Hospital negotiates contracts, patients not covered

Last October, emergency room physicians at St. Mary TMs became independent, and that's when the trouble started for patients with several types of insurance not accepted by the doctor's group.

"Contracts between Anthem Blue Cross, HealthLink and United were being negotiated with capitol emergency physicians. These are the three insurance companies that during this time change of healthcare have contracted negotiations," St. Mary TMs Administrative Marketing Director Beverly Stafford said.

St. Mary TMs said they keep the insurance problems quiet because of federal privacy rules.

"St. Mary TMs treats all patients regardless of their ability to pay. Unfortunately there is a federal regulation that prohibits all hospitals in this country from having any financial discussions with a patient prior to treatment," St. Mary TMs Administrative Marketing Director Beverly Stafford said.

So it becomes the patient's prerogative to ask to be taken to a specific hospital and find out what insurance they accept before being treated.

"In a event that you are conscious, alert, and able to answer questions appropriately, we will take you to your choice, and transport you to a facility of your choice." Cole County EMS Director Mike Shirts said.

Stafford said that St. Mary TMs has had nearly 60 complaints since the doctor's group started re-negotiating it's insurance contracts.

"St. Mary TMs hospital has contacts with all of these payers," Stafford said. "Capitol emergency physicians' goal is to have contracts with all these payers. It was just a matter of negotiating the terms with the physicians and the insurance payers.

Capital Region Medical Center's Jim McMillan said that they also have independent physicians working in their ER. However they don't have problems with health insurance companies kicking in to take care of their patients' bills.

Columbia hospitals, Boone Medical Center and University Hospital, said their ER's have not had problems with their patients having health coverage.

But McMillan said that negotiating new contracts with insurance companies can take time, sometimes up to six months.

Stafford said a contract between United Healthcare and the ER physicians went into effect June 1.

She said negotiations with Anthem Blue cross and HealthLink have been finalized and they will accepted within a few weeks.

Stafford said the hospital is also working with people who have already been denied coverage once to get their bills settled through the new insurance contracts.