However, they have different views of the facts that could leave more than 50,000
"We're preparing for (NMMC-Tupelo) to be out of network on
"We do not believe their termination notice is valid and feel strongly that the hospital system should honor its contract as we continue a thorough review of the claims they are disputing," said
Both entities agree NMMC community hospitals in
"I fully appreciate the urgency of this matter and expect the continued cooperation of both UHC and NMHS as the field work progresses," Chaney said.
The urgency comes as open enrollment season for 2017 health insurance policies are in full swing. The potential network changes affect those who purchase policies from
Source of trouble
The trouble between
"We sent them files with tens of thousands of claims," Spees said.
NMHS staff have researched the individual claims, eliminated duplicates and pulled out claims on patients with high deductible plans that would be responsible for the entire bill from compilation of problem claims, Spees said. The claims weren't denied, which would have flagged them to be adjusted and resubmitted, Spees said.
Based on analysis and dialogue with
"United incorrectly processed them under the wrong program," Spees said.
"We have reviewed over 11,000 claims to date, and so far nearly every claim was paid correctly," a United spokeswoman said. "We have also offered multiple times to have an independent, third party review the claims to further support this analysis, but NMHS has refused."
Some issues are being addressed. The example published in a full-page ad in the
(c)2016 the Northeast Mississippi Daily Journal (Tupelo, Miss.)
Visit the Northeast Mississippi Daily Journal (Tupelo, Miss.) at www.djournal.com
Distributed by Tribune Content Agency, LLC.