baptist health medical group general surgery :: Article CreatorHumana Patients Lose Coverage At Baptist Health Medical Group - Whas11.com
The two companies were unable to reach an agreement Friday, leaving some patients little to no options.
LOUISVILLE, Ky. — Baptist Medical Health Group is no longer accepting some patients insured through Humana, after the companies were unable to reach an agreement Friday.
After months of negotiations, there was no agreement on a new contract - meaning Baptist Health Medical Group will be out of Humana's network for Medicare Advantage and employer-sponsored commercial plans.
Patients, like Amy Derby, are now left frantic and unsure of where to turn next.
"Everybody's lost," Derby said. "And you try and talk to a social worker or a healthcare advocate here at the hospital and they don't even know."
Derby has been insured through Humana for 13 years. She tells WHAS11 that she was notified in late August of the negotiation problems between Baptist, Humana and Medicare.
She received a letter from Baptist printed on Sep. 13, but delivered Sep. 18, stating that her doctor at Baptist was dropping her as a patient because of her Humana Medicare Advantage Plan. That change went into effect Sept. 22.
What does this all mean? Higher out-of-pocket costs for medical services.
"Now that I'm out of network, I can't get any actual answers on what copays, hospitalizations, or procedures are going to be," Derby said.
Derby is now tasked with finding a new general practitioner cardiologist and hematologist oncologist.
"I'm just in a tizzy like everybody else," she said.
Humana sent the following statement to WHAS11 on Tuesday, Sept. 26:
After several months of negotiations, Humana and Baptist Health Kentucky were unable to reach a new agreement prior to the expiration of the contract term on September 22, 2023. As a result, physicians of Baptist Health Medical Group are no longer considered in-network when providing services to Humana's Commercial Group accounts and Medicare Advantage members. This change does not affect coverage for services provided directly by Baptist Hospital, nor does it impact Medicaid recipients enrolled in Humana's Healthy Horizons of Kentucky program. Humana will continue to have discussions with Baptist Health in the hope of ultimately reaching an agreement.
We understand that changing healthcare providers can be difficult. Humana maintains a large network of highly-rated providers in Kentucky. Humana will work with our Medicare Advantage and Commercial Group members to help them select new in-network providers to ensure their care is not interrupted. In some cases, it may be beneficial for a member to request a period of continued care with their current Baptist Health Medical Group provider for a transition period. If this becomes necessary, Humana members will continue to receive their same level of in-network benefits during this transition period. We encourage our members to call Humana Customer Care if they need personal assistance.
In a statement sent to WHAS11, Baptist Medical Health Group stated, in part: "As caregivers, nothing is more important than ensuring our patients have access to the care they need, when they need it. We understand this process has been frustrating for our community, but we will continue to advocate for those we serve."
The change only effects Baptist Health Medical Group, Baptist Health hospitals are still in-network for Humana.
Baptist Health is encouraging patients to call Humana at the number on the back of your insurance card to learn about your plan's out-of-network benefits.
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