WWU employees on Uniform Medical Plan may lose network access to PeaceHealth St. Joseph Medical Center
Regence, the third-party administrator for Uniform Medical Plan, has sent a letter to UMP members in Whatcom, San Juan and Skagit counties regarding the as-yet-unsuccessful contract negotiations between Regence and PeaceHealth St. Joseph Medical Center and PeaceHealth Medical Group.
As the letter states, the current contract ends March 31, 2011. If the negotiations aren’t successful, PeaceHealth St. Joseph Medical Center will remain a covered hospital option for UMP members under a separate contract between the Medical Center and HCA.
What will change is the coverage level for professional providers at the Medical Center and the Medical Group (e.g., anesthesiologists, radiologists, surgeons, pathologists). They will become out-of-network providers with the subsequent increase in the proportion of cost going to members if the members continue to use those physicians.
The letter outlines information and resource numbers for UMP members with concerns about ongoing care and emergency care. It also provides help for UMP members in finding other professional providers in the area.
It’s important to note that this potential loss of in-network status for these physicians within the Medical Center and Medical Group only applies to the services provided within the Bellingham PeaceHealth Medical Center and Medical Group, not the other PeaceHealth facilities and their professional providers in other locations.
Regence BlueShield has a large network of contracted providers in Whatcom, San Juan and Skagit counties. To ensure receipt of the network level of benefits, members should select a provider who is part of the Regence PPO network. Members may use the Provider Search Tool to find network providers in the area. Employees do have the option of continuing to see PeaceHealth Medical Group providers after March 31, but out-of-pocket costs will generally be higher.
In the meantime, Regence will continue working diligently with PeaceHealth St. Joseph to come to a successful contract resolution. UMP members will be notified immediately in the event that an agreement is reached. Otherwise, the transition will occur as outlined above. Members should consult their UMP Certificate of Coverage or call UMP Customer Service at 1-888-849-3681 (TTY: 711) for help with questions.