HealthPartners leaving UnitedHealthcare's Medicare Advantage network over high claim denial rate
MINNEAPOLIS — HealthPartners announced Tuesday that it plans to leave UnitedHealthcare's Medicare Advantage network starting next year.
The nonprofit health care organization says it made the decision because "UnitedHealthcare delays and denies approval of payment for our patients' Medicare Advantage claims at a rate unlike any other insurer in our market."
HealthPartners claims its denial rate with UnitedHealthcare has been up to 10 times higher than that of other insurers it works with.
"Unfortunately, some of UnitedHealthcare's practices create unnecessary waits and delays for patients, and they interfere with our ability to provide patients with timely and appropriate care," HealthPartners said in a statement.
HealthPartners says it is unusual to leave a health plan network but the decision came after a year of negotiations.
The change applies to care provided at HealthPartners and Park Nicollet clinics and hospitals, including Methodist, Regions and Lakeview hospitals.
HealthPartners will be offering additional resources and information to help those affected by the change, which can be found online.
UnitedHealthcare issued a statement in response, saying the company "proposed a contract that provided solutions HealthPartners sought to continue participating in our Medicare Advantage network. Rather than using the remaining time on our contract to implement these solutions, HealthPartners rescinded its position and is now putting Medicare Advantage patients in the middle of our negotiation."
The UnitedHealthcare spokesperson added, "We hope HealthPartners shares our commitment to provide access to care for all Minnesota and Wisconsin residents."
The company spokesperson said its Medicare Advantage members should still have access to HealthPartners facilities until the end of the year, and they will continue to work toward a compromise.
Last week, 11 people were arrested outside the UnitedHealthcare headquarters in Minnetonka for protesting what they alleged is the company's practice of not paying for care.
An organizer for the protest said that UnitedHealth Group leadership has "refused to acknowledge that prior authorizations and claim denials are a widespread problem."