Walsh Benefits - Carrier Facts

Southhampton Hospital Terminating from the UnitedHealthcare and Oxford Networks
4/29/2008

Negotiations Ongoing: Southampton Hospital Terminating from the UnitedHealthcare and Oxford Networks

We are committed to providing access to comprehensive, quality and affordable health services to our members. To that end, we want to inform you of changes in our network so your client's employees do not incur any unnecessary out-of-network costs. We are currently in the midst of negotiations with Southampton hospital and hope we will be able to come to a new contractual agreement. Our existing contract with Southampton Hospital terminated effective April 7, 2008. As a result, we are sending communications to groups and members prepare them that Southampton Hospital will be considered out of network beginning June 7th, 2008.

To minimize any disruption this may cause your clients and their employees, and to provide them sufficient time to find another participating hospital, care received at Southampton Hospital will be considered in-network for Oxford and UnitedHealthcare through June 6, 2008.

The enclosed samples of the Oxford and UnitedHealthcare Benefits Administrator and Member letters provide details regarding transition and continuation of care.

If a member's primary care physician (PCP) becomes a non-participating provider and, as such, the member is required to select a new PCP, the member will be directed to call Customer Service at the number on their member ID card. Customer Service representatives are available to help members with the PCP selection process. Members also may visit www.oxfordhealth.com or www.myuhc.com, as appropriate, to view an online directory of participating providers. If we do not hear from the member by the date his or her PCP leaves the network, we will assign the member an available PCP from the member's geographic area. The member's effective date with this PCP will be the date on which the member's previous PCP became disenrolled. If a member is not satisfied with our selection, he or she may call Customer Service at the number on their member ID card to change their PCP.

A PCP or specialist should not refer a member to Southampton Hospital for any treatment or test. Instead, members should be referred to one of the major neighboring participating hospitals in our network, including: Brookhaven Memorial Hospital, Stony Brook University Hospital and Southside Hospital. As is our standard policy, care for an emergency illness, injury or condition, will be reimbursed on an in-network basis.

Our primary commitment is to provide access to comprehensive, quality and affordable health care services and we continue to work diligently to achieve this goal. If you have any questions, please call Client Services at 1-888-201-4216.

Return