UnitedHealthcare and Wellstar settle on new contract for patient coverage

(PHOTO Courtesy of Wellstar Health System)

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(PHOTO Courtesy of Wellstar Health System)

Patients of Wellstar doctors and hospitals who have UnitedHealthcare insurance will once again be insured as in-network patients, starting July 1.

Wellstar and UnitedHealthcare last fall decided they could not agree on a new contract, and patients have been dealing with the fallout ever since. That meant patients who had UnitedHealthcare insurance had to pay out-of-network prices whenever they got care from Wellstar, as if they weren’t insured.

During the impasse, UnitedHealthcare said Wellstar wanted to charge too much. Wellstar said UnitedHealthcare was underpaying them. At the time the contract ended, an estimated 80,000 United members were affected.

Now, the two companies have a contract again, starting Friday. Wellstar said patients may begin now booking their appointments for Friday and after.

Patients across Georgia and the U.S. are finding themselves more frequently caught in the middle when big health systems and insurance companies disagree. Both industries see billions of dollars in revenues and spend heavily on lobbying to influence Georgia and federal lawmakers.

Wellstar and UnitedHealthcare issued identical press releases this week, with few details about the new deal. Both sides called it a “multi-year agreement,” but didn’t specify when the agreement’s end date would be. Asked how long patients’ insurance plans would now work at Wellstar, a media representative for UnitedHealthcare who did not want his name used, said, “that we can’t reveal. The details regarding the length of the agreement are confidential.”

The new contract insures care with Wellstar clinicians, hospitals, health parks and clinics. It applies to people enrolled in UnitedHealthcare employer-sponsored, individual and Medicare Advantage plans. According to the announcement, it expands access to Wellstar skilled nursing facilities, home health and hospice care.

ExploreEARLIER IN THE AJC: Wellstar/United insurance contract ends without a deal, affecting thousands