Healthcare Finance News January 11, 2024
The health system cited denials and delayed prior authorization requests in making the move, as well as its financial position.
Since January 1, Baptist Health, based in Louisville, Kentucky, has been out-of-network with UnitedHealthcare and Centene’s Wellcare Medicare Advantage plans, citing denied and delayed prior authorization requests and payments from the insurers.
It was the same reason cited by Baptist Health when it went out-of-network with Humana’s Medicare Advantage and commercial health plans last fall.
Baptist said it had been working for several months to secure a new contract with WellCare, but made little progress. The most important issue in the discussions with Wellcare, according to the health system, was to protect the patient/clinician relationship and preserve care access.
While...
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