The fight between Mednax, the physician-staffing firm and UnitedHealth Group has a ripple effect that is impacting innocent bystanders. People who had anesthesia, parents who have babies in intensive care and even moms who have high-risk pregnancies could be receiving surprise bills for the care they received due to this feud.
What is happening?
There are certain Mednax doctors that can possibly be out of UnitedHealth’s network as early as this month! When this happens, UnitedHealth customers who have seen one of the doctor will be required to pay the full cost as the service will not be considered out-of-network.
- UnitedHealth customers in Arkansas, Georgia, North Carolina and South Carolina will be effected at staggered dates throughout this year. Mednex’s anesthesiologists, neonatologists and obstetricians will be out-of-network for UnitedHealth patients.
- According the Commonwealth Fund, Arkansas, Georgia and South Carolina do not have any surprise billing protection for patients and North Carolina has limited protections.
What is Mednax saying?
Roger Medel, Mednax CEO stated that UnitedHealth’s terminations “were unilateral, without warning and unprecedented.” He also shared that “administrative costs of processing those bills and the time and stress for patients receiving and resolving these bills will increase meaningfully,” and he is “concerned how these actions may interfere with the ongoing discussions in Washington surrounding surprise billing.”
What is UnitedHealth Saying?
UnitedHealth says that Mednax doctors charge too much. In fact, a UnitedHealth spokesperson said “Mednax’s charges are more than 60% higher than the average cost of the other doctors that provide similar services in these states,”
According to UnitedHealth, proposals were submitted for lower payment rated to Mednax’s doctors in Georgia, North Carolina and South Carolina in November but they never received any counter offers.
In rebuttal, Mednax stated that the payment terms presented by UnitedHealth were on a take-it-or-leave-it basis and that their request for a 60-day extension was rejected.
As these arguments continue there will undoubtedly be more billing horror stories as people experience the fallout.