UnitedHealthcare Negotitations


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We believe Health Comes First

Saint Agnes Medical Center has been working hard to reach a fair agreement with UnitedHealthcare that more appropriately covers the true cost of the care we provide to patients.

Unfortunately, UnitedHealthcare has forced Saint Agnes Medical Center out of its network, effective July 1, 2024. This impacts patients who are covered by UnitedHealthcare Commercial HMO, PPO, and Medicare Advantage products. UnitedHealthcare has disrupted your access to Saint Agnes Medical Center hospitals, facilities, and physicians.  

Why did UnitedHealthcare force Saint Agnes Medical Center out-of-network?

The payment we receive from UnitedHealthcare does not appropriately cover the true cost of the care we provide. We rely on fair reimbursement so we can sustain the high-quality care people depend on and need, but UnitedHealthcare frequently denies, delays, and underpays our hospitals and providers. We are asking for fair reimbursement, which UnitedHealthcare continues to deny us. 

UnitedHealthcare has misrepresented our request for fair payment as a not-for-profit health system. In truth, we are seeking a multi-year agreement with less than 5% increases on average, so that we can continue to invest in the medical innovations, technologies, and programs that people rely on. UnitedHealthcare claims to be concerned about lowering costs for members, but it is growing its own bottom line by trying to pit patients and providers against each other. It rakes in billions by choosing to increase member’s monthly out of pocket costs, deny claims and underpay health systems like ours and others across the country.  

Continuity of Care

Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, Saint Agnes cannot qualify you under UnitedHealthcare's process.

  • UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify.
  • UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
  • If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at Saint Agnes and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Center for Medicare and Medicaid Services by following these instructions or calling 800-985-3059.
  • If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
  • If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period of time. 

Your provider’s office can support in filling out the continuity of care form from UnitedHealthcare.

We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at Saint Agnes Medical Center. We will not give up trying to reach a fair agreement with UnitedHealthcare that brings us back in-network.

If you do not find the answers to your negotiation-related questions on this site, please contact us directly via this website through our contact us page or call our patient line at (559) 712-4422 This website will be updated as our negotiations continue, so please check back for the most up-to-date information. 

What You Can Do

  • Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with UnitedHealthcare, you should always visit the closest emergency department if you experience a medical emergency.  
  • Apply for continuity of care immediately. Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, Saint Agnes cannot qualify you under UnitedHealthcare's process.
    • UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify.
    • UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.  
    • If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at Saint Agnes and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Center for Medicare and Medicaid Services by following these instructions or calling 800-985-3059.
    • If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
    • If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period of time.
  • Call the number on the back of your insurance card and urge UnitedHealthcare to keep your in-network access to Saint Agnes Medical Center and its doctors.
  • If you receive insurance through your employer, ask about other health plans that include Saint Agnes Medical Center. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.
  • If you have Medicare Advantage or bought a UnitedHealthcare plan from the ACA marketplace (also known as the Health Insurance Exchange), contact your health insurance agent/broker for options to switch plans. We work with many other health plans that will give you in-network access to Saint Agnes.    

We believe Health Comes First  

We know how important it is for you and your family to receive care from the trusted doctors, nurses and staff at Saint Agnes Medical Center. As a not-for-profit, local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. We are working hard to reach a fair agreement with UnitedHealthcare, but we need them to do the same—and put patients first. Our request to UnitedHealthcare is simple: to be paid fairly and in line with other providers in our market. We cannot maintain access to the care and services patients depend on and need without fair agreements from commercial health insurers who reimburse us for the cost of care.    

Find out how Saint Agnes Medical Center invests in our community. Health insurers, including UnitedHealthcare, are posting record-breaking profits for shareholders, while we are expected to cover gaps. UnitedHealthGroup, the parent company of UnitedHealthcare, made more than $22 billion in 2023 alone. Saint Agnes Medical Center cannot continue to do more with less. To learn more, visit Health Comes First

Frequently Asked Questions

If you do not find the answers to your negotiation-related questions on this site, please contact us directly via this website through our Contact Us page or call our patient line at (559) 712-4422. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.

For now, nothing changes. You should continue to visit Saint Agnes, its facilities, and physicians as you normally would. We are working hard to reach a new agreement before July 1, 2024, to avoid care disruption, but UnitedHealthcare needs to step up and put patients first.

Saint Agnes is negotiating with UnitedHealthcare for new agreements that cover the cost of the care we provide patients with UnitedHealthcare commercial (employer-sponsored) or Medicare Advantage health plan. Our current contract will expire July 1, 2024. Though negotiations are a routine part of doing business, UnitedHealthcare is unfortunately misrepresenting the situation and not putting patients first. They continue to not reimburse us fairly and deny or underpay claims, so they can use those dollars to bolster their own pockets and those of their shareholders. UnitedHealthcare also refuses to make meaningful payments to providers who are owed billions of dollars in back claims payments following a ransomware attack on UnitedHealthcare.

As a trusted local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. However, UnitedHealthcare is more interested in increasing their profits instead of providing rate increases that adequately cover the true cost of what it takes for us to deliver care. For the past three years, United Healthcare has increased profits by double digit percentages. Increasing profits in 2021 by nearly 12% and more than 14% in both 2022 and 2023. We cannot maintain access to the care and services patients depend on and need without a fair agreement from UnitedHealthcare.

Our current agreements will expire effective July 1, 2024.

UnitedHealthcare commercial (employer-sponsored) or Medicare Advantage health plans.

Saint Agnes Medical Center, its facilities, and employed providers are impacted by these contract negotiations.

While our negotiations with UnitedHealthcare continue, you can take these steps to protect your access to in-network care with Saint Agnes:

  • Call the number on the back of your insurance card and urge UnitedHealthcare to keep your in-network access to Saint Agnes and its doctors.
  • If you receive insurance through your employer, ask about other health plans that include Saint Agnes. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.
  • If you have Medicare Advantage or bought a UnitedHealthcare plan from the ACA marketplace (also known as the Health Insurance Exchange), contact your health insurance agent/broker for options to switch plans. We work with many other health plans that will give you in-network access to Saint Agnes.
  • If you have UnitedHealthcare Medicaid, you may be able to choose other health care coverage that allows you to access Saint Agnes. Call 1-800-541-5555 to see if you can change in your plan.

If you are already admitted to the hospital before July 1, 2024, you will be covered at in-network rates through the end of your inpatient stay.

We understand that some patients may have appointments scheduled on or after July 1, 2024. If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled before July 1, 2024. If you are unable to reschedule your appointment or choose to keep your appointment, you may have to pay higher out-of-pocket costs for your care with Saint Agnes if UnitedHealthcare forces us out of its provider network.

Patients will always have in-network access to our emergency rooms, regardless of our status with UnitedHealthcare. If you experience an emergency, you should always visit the nearest emergency room. Patients needing emergency care can receive in-network treatment until the patient is stable.

This website will be updated as our negotiations continue, so please check back for the most up-to-date information.