Colorado Medical Society

http://dev.cms.org/articles/unitedhealthcare-medicare-advantage-network-changes-in-colorado/

UnitedHealthcare Medicare Advantage network changes in Colorado

Wednesday, June 25, 2014 10:29 AM

The Colorado Medical Society was advised by representatives of UnitedHealthcare (UHC) that some physicians might be receiving notices discontinuing their participation in UnitedHealthcare’s Medicare Advantage network, effective Sept.15, 2014. Specific to Colorado:

• These changes will impact a small number of physicians—less than 1 percent of the existing 7,600+ network of participating physicians, primarily PCPs.
• The notifications to physicians and Medicare Advantage members will occur in advance of the annual Medicare open enrollment period this fall.
  • Letters and contract amendments were mailed recently to physicians who have been deselected, and letters to impacted Medicare members will be mailed in the coming weeks.

  UHC advised that the physicians affected have a relatively small number of UHC Medicare Advantage patients in their practices. UHC must maintain access for their members so as part of their network restructuring they tried to ensure that there would still be a sufficient number of physicians in the same area who could care for their Medicare Advantage members. However, there is an appeal process for the termination. If you don’t feel UHC followed the terms of your agreement or if there is additional information regarding your practice that you think is important to this decision you are encouraged to submit an appeal. Any impacted physician with questions concerning these changes is encouraged to contact their local network representative or UnitedHealtcare’s provider call center at provider call center at 1-800-509-3023.

  For more information including on how to appeal, click here.