“Surprise” bills from medicalpersonnel who are not in network, despite working at in-networkfacilities, are becoming a major scourge for patients. (Photo:Getty)

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UnitedHealth Group has warned some 700 hospitals that staffingfirm Envision Healthcare could be out of network next year.

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Hospitals were warned that they and patients could be in for bigbills, according to Modern Healthcare, because of its emergency department billing practices.UnitedHealth blames the failure of contract negotiations betweenitself and Envision because Envision “demands to be paid much morethan Medicare pays for the same services,” says the report.

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If the companies do not resolve their differences and extendEnvision's in-network status past Dec. 31, patients could be theones faced with big out-of-network bills if they're treated by anEnvision-staffed emergency department or by some other departmentsfor which Envision also provides staff. In addition, the hospitalsthemselves could find themselves stuck for the bills foruncompensated care.

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Related: Is outlawing surprise medical bills really inconsumers' best interests?

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“Surprise” bills from medical personnel who are not in network,despite working at in-network facilities, are becoming a majorscourge for patients.

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UnitedHealth's letter said, “In the event patients receiveservices from an Envision provider, you may experience a decreasein patient satisfaction driven from higher out-of-pocket costs andpatient confusion.”

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Envision, for its part, said in a statement that UnitedHealth'sletter is “filled with half-truths and inaccuracies.”

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Modern Healthcare quotes Envision saying, “We've workedhard to shift to an in-network relationship with United and nowthey want to undo all that progress in one day.”

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The dispute has been ongoing for months, with Envisionsupposedly sending large “surprise” bills to patients. In March,Envision sued UnitedHealth, the report says, “claiming the insurerviolated their contract by refusing to add Envision doctors to itsnetwork, unilaterally lowering payment rates, and then trying tocollect more than $140 million in what it considered overpaymentsto the staffing firm.”

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In April the suit was dismissed, and the judge told thecompanies to enter arbitration. However, UnitedHealth set up awebsite that targeted Envision's “outrageous billing practices,”citing the staffing firm's physician charge of $992 for anemergency department visit for a patient with chest pain, whilepointing out that in-network doctors instead charge only an averageof $351.

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UnitedHealth isn't the only one complaining about Envision'sbilling, with a Yale University study from 2017 revealing thathospitals outsourcing ED care to Envision saw rates forout-of-network care, tests and admissions from EDs all rise.

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Private equity firm Kohlberg Kravis Roberts & Co. isexpected to close on the purchase of Envision in October; the dealwas approved for $9.9 billion in cash and assumed debt earlier thismonth.

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