Attention UNITEDHEALTHCARE/ OXFORD Subscribers
EastEnd Health Alliance hospitals (Eastern Long Island Hospital, Peconic Bay Medical Center and Southampton Hospital) are currently in active negotiation for contract renewal with OXFORD/UNITED. We are making every effort to ensure that ongoing negotiations are productive, and are hopeful a new contract will be reached prior to contract expiration.
NOTE: Fully insured plans with UnitedHealth/ Oxford, such as—Oxford Liberty and Oxford Freedom Plan, remain in network are unaffected at this time.
As of 12 midnight on July 15, 2011 UNITED self insured contract(s) with the member hospitals of the East End Health Alliance will expire. These hospitals include-- Eastern Long Island Hospital (ELIH), Peconic Bay Medical Center (PBMC) and Southampton Hospital (SH) .
Locally, self-insured plans include, but are not limited to, East End Health Plan/ United Healthcare. Subscribers should contact plan administrators to request clarification of out-of-network benefits.
How are you affected as a self insured participant?
• If you have an emergency and require treatment in the Emergency Room or need to be admitted due to an emergency, your care is covered by law.
• If you're self insured plan includes out-of-network coverage, UNITEDHEALTHCARE/ OXFORD will cover the elective hospital services, but you will be responsible for your deductible and co-insurance obligations.
If you have already scheduled a service (test, procedure, admission, etc) at one of the Alliance hospitals for after July 15, 2011 can you still have it?
If you have received authorization from UNITEDHEALTHCARE/ OXFORD prior to July 15, 2011, UNITEDHEALTHCARE/ OXFORD will honor it and cover the cost of services under your in-network benefit.
How will your maternity coverage be affected?
If you have entered the second trimester of pregnancy as of July 15, 2011, your health care coverage will not be impacted through your delivery and post-partum care.
Why did the contract expire without a new contract to replace it?
We understand how important it is for families to know that when their community hospital is needed, their care will be covered by their health care insurance plan. However, providing quality health care requires an adequate level of payment from health care plans. The current level of reimbursement from UNITEDHEALTHCARE/ OXFORD and the proposed increases are inadequate to sustain our quality goals. We owe it to the communities that rely on us to be the best we can. Ultimately, it is the patients' interests we are trying to preserve.
Are your physicians impacted by this?
The termination at hand is between East End Health Alliance hospitals and UNITEDHEALTHCARE/ OXFORD, not the participating doctors. Members of the Alliance medical staff are expected to remain in network at least until September 15, 2011.
When will this be settled?
Please be assured that we are doing everything that we can to resolve the matter between UNITEDHEALTHCARE/ OXFORD and the East End Health Alliance member hospitals, but it's not possible to predict if or when the contract will be settled. Be assured though that we are doing our best to bring this negotiation to a successful conclusion. We prefer to be a participating provider with UNITEDHEALTHCARE/ OXFORD.
Who can you call if you have questions?
If you have questions regarding your coverage or an upcoming hospital visit, you may call:
Eastern Long Island Hospital at 631-477-5100
Peconic Bay Medical Center (Central Registration) at 631-548-6018
Southampton Hospital at 631-726-8555