Covenant now accepting Presbyterian Health Plan insurance, UMC already did

May 19--Covenant Health System is now accepting Presbyterian Health Plan insurance.

The hospital entered negotiations with the provider on April 1.

Brandon Fryar, CFO for Presbyterian Health Plan, said the provider primarily covers health care in New Mexico, particularly the eastern region.

About 10 percent of the health plan's 440,000 members from eastern New Mexico and Texas seek services in West Texas, he said. "It's a small percentage," he said.

It's an effort to provide members with additional services, Fryar said. "We've expanded our network of participating hospitals," he said.

The plan was a strategic move for Covenant, said Lindy Lauderdale, vice president of managed care for Covenant Health.

Patients from Clovis, Hobbs, Portales and Ruidoso are commonly treated at the hospital, she said. "They now have access to some services we offer that they have not had access to in the past," she said.

The services were available to patients with that particular health plan before April, she said. The difference is the costs.

"They would have to pay more out-of-pocket costs," Lauderdale said. "Now it's paid at the highest level of benefits."

A plan to negotiate an agreement has been in motion for months, she said.

The contract allows Presbyterian Health Plan members to seek care at any of the five Covenant Health System hospitals including Covenant Medical Center, Covenant Children's Hospital, the Specialty Hospital and the Plainview and Levelland hospital locations, Lauderdale said.

Covenant is not the only hospital in the region to accept Presbyterian Health Plan, Fryar said. A contract was already in place with University Medical Center.

Julie Crow, manager of contract negotiations for University Medical Center, said it's been accepted at UMC since April 2004.

"We'd had a long-standing relationship with them," she said. "We've had a great relationship with them and continue to do so. Their health care members have been coming to us for quite some time."

About 4 percent of Presbyterian Health Plan users seek services at UMC.

Crow said the drive to Lubbock is easier than a drive to Albuquerque for most members who seek services from UMC. "It's geographically driven," she said.

She also attributes the volume to UMC's Level 1 Trauma Center designation to the Presbyterian Health Plan patient volume.

"We are the only burn ICU in the region," she said. "UMC definitely brings those quality services that others can't bring in the region."

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