The insurance company at risk of losing coverage in ThedaCare health care system facilities said Tuesday it was proposing two alternatives to prevent customers from experiencing disruptions in service.
Network Health, based in Menasha, said it was offering ThedaCare either a new five-year partnership or a shorter extension of a previous agreement through 2016.
In either case, Network Health President Sheila Jenkins said she was hoping to avoid a disruption of service for health care clients in the Shawano area and surrounding region.
“The past 30 days have been difficult,” Jenkins wrote in a statement directed at customers. “Your patience and support has been overwhelming despite the uncertainty.”
The statement said a response from ThedaCare was requested by Jan. 29.
ThedaCare spokeswoman Megan Mulholland issued a statement Tuesday that did not indicate whether the Appleton-based health care provider would agree to either of the insurer’s new proposals.
“ThedaCare hopes to find a resolution with Network Health Plan that meets the needs of our patients and providers,” Mulholland said. “If we do reach agreement, we will promptly communicate that news with plan members, employers and the public.”
ThedaCare announced in mid-December that it would no longer accept Network Health insurance coverage, effective July 31, because of a disagreement over how much the insurer would reimburse ThedaCare for medical services provided. The two companies have had a partnership for the past five years.
The threatened breakdown in insurance coverage affects thousands of Network Health clients in Wisconsin. But the situation is particularly impactful in Shawano because ThedaCare just opened its new ThedaCare Medical Center-Shawano this fall, making it the area’s dominant health care provider.
Network Health covers an estimated 3,700 people in Shawano County with health insurance, most of them senior citizens who rely on the company to administer Medicare benefits. The Menasha-based insurer also serves employees at several local businesses and other workplaces.
The two sides met last week to try resolving their differences, but no deal was announced and each accused the other of squashing any immediate hope of compromise.
Of immediate concern is the mid-summer disruption of service that could mean Shawano-area consumers would lose insurance coverage at ThedaCare facilities. Both sides have expressed an interest in extending their current partnership through 2016, but no such temporary solution has been negotiated.
“Although we were disappointed in ThedaCare’s decision to end our partnership,” Jenkins said Tuesday, “we hope they’ll move forward quickly to accept one of our proposals in the best interests of our mutual community.”
Categories
