upmc and highmark

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Since: Apr 09

erie pa

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#1
Aug 30, 2011
 
TWhat the hell is upmc doing now ? They are going to. Refusing highmark insurance becase highmark is trying to buy west penn . I think highmark is trying to do something good . Saving a company and jobs .
But upmc finailly got a foot in erie area and is going to be getting rid of all orignal hamot employees and replace with all the grads from pittsburgh . And with that , only use there insurance . Hamot used to be the premire hospital to go to . But since they were talking about merging with upmc years . Hamot has down hill fast . My aunt went to hamots er a few weeks ago and it took them 6 hours to see her an then another 2 hours for them to do anything once she was in back . She couldn't stop throwing up . Wow they gave her a basin . That cost her what $75 . But while she was waiting the registration came . They are the only fastest people in the er .

“Love Freedom, Thank a Soldier”

Since: Feb 08

Erie,PA

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#2
Aug 30, 2011
 
WOW....
cheetos

United States

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#3
Aug 30, 2011
 
if you check out HM website it clearly states when they will no longer accept that insurance. It was in the contract when UPMC bought Hamot. I found this out 3 weeks ago by accident. I believe it is 2013.
My question was will your doctor accept HM if he works under UPMC Hamot?
CRANK

North East, PA

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#4
Aug 30, 2011
 
My question is, Hamot is a State Department of Health approved Trauma Center. Will the state permit Hamot to remain the regional Trauma Center knowing they refuse to accept the largest health insurance plan in the region. Would UPMC be willing to see the Trauma Center designation given to St. Vincent, now with an Ohio association, that would open them up to even more negative competition. The fact that UPMC and Highmark CEO's hate each other should not preclude the DoH from stepping in and demanding that a State licensed regional Trauma Center accept the insurance. Flo? Pat? Jane?

Since: Feb 10

Erie, PA

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#5
Aug 30, 2011
 
Trauma accreditation has nothing to do with accepting insurance.

The issue between Highmark and UPMC comes down to Highmark owning a health care system (should the deal go through, which it looks like it will) and will direct patients to that system. Moreover, because Highmark knows the amounts it pays every hospital, it has an unfair competitive advantage.

By the way, Highmark will have to invest anywhere from $500 million to more than $1.5 billion in West Penn. Where does it get its money? From premiums. They control the health care insurance market in western PA already; so the outrageous rates they've charged for years gave them a war chest on the backs of their subscribers.

I talked to an insurance broker a few weeks ago. They quoted Highmark coverage for a customer, and Highmark slashed their rate by 25%. Why? Because UPMC's decision regarding Highmark has opened the door for other insurers to compete in the western PA market.

Since: Feb 10

Erie, PA

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#6
Aug 30, 2011
 
cheetos wrote:
if you check out HM website it clearly states when they will no longer accept that insurance. It was in the contract when UPMC bought Hamot. I found this out 3 weeks ago by accident. I believe it is 2013.
My question was will your doctor accept HM if he works under UPMC Hamot?
What do you mean, "it was in the contract"? Hamot has a contract with Highmark through 2013. UPMC didn't even take any position on Highmark until Highmark tried to cover up that it was buying the West Penn system. So all that was in the agreement between Hamot and UPMC is that all agreements continue under their current terms.
cheetos

United States

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#7
Aug 30, 2011
 
UPMC, the area’s largest health care provider says it won’t renew its contract with Highmark, the area’s largest health insurer.

UPMC says:“With Highmark having announced its intention to compete with UPMC as a provider, there cannot be any prospect of a contract renewal between UPMC and Highmark.”

The contract expires June 30, 2012.

Trying to find the PETBF site that I had orginally found the most information on.
cheetos

United States

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#8
Aug 30, 2011
 
needed to add, the artical was describing details of job cuts, insurance changes and the purchase of Hamot. According to that, UPMC was only going to accept HM until 2013. I'm searching my azz off here to find that for you.
CRANK

North East, PA

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#9
Aug 30, 2011
 
ErieRealist wrote:
Trauma accreditation has nothing to do with accepting insurance.
The issue between Highmark and UPMC comes down to Highmark owning a health care system (should the deal go through, which it looks like it will) and will direct patients to that system. Moreover, because Highmark knows the amounts it pays every hospital, it has an unfair competitive advantage.
By the way, Highmark will have to invest anywhere from $500 million to more than $1.5 billion in West Penn. Where does it get its money? From premiums. They control the health care insurance market in western PA already; so the outrageous rates they've charged for years gave them a war chest on the backs of their subscribers.
I talked to an insurance broker a few weeks ago. They quoted Highmark coverage for a customer, and Highmark slashed their rate by 25%. Why? Because UPMC's decision regarding Highmark has opened the door for other insurers to compete in the western PA market.
I haven't looked at the new legislation, but the prior EMS authorizing legislation, Act 45, that gave the DoH authority to appoint regional trauma centers, did contain provisions that stated the center must accept all reasonable reimbursements for trauma related services to be considered for designation. The rationale was because of the implied consent provision in the EMS prehopsital provisions, that essentially directed prehopsital EMS personnel to deliver patients unable to give consent to a state approved Trauma Center. The trade off was if the hospital wanted the additional trauma business, they had to take all comers, and their reimbursement, in exchange for essentially a monopoly. I have not read anything to indicate that provision has changed. Have you? If so where is it contained?
haha

Erie, PA

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#10
Aug 30, 2011
 
CRANK wrote:
<quoted text>I haven't looked at the new legislation, but the prior EMS authorizing legislation, Act 45, that gave the DoH authority to appoint regional trauma centers, did contain provisions that stated the center must accept all reasonable reimbursements for trauma related services to be considered for designation. The rationale was because of the implied consent provision in the EMS prehopsital provisions, that essentially directed prehopsital EMS personnel to deliver patients unable to give consent to a state approved Trauma Center. The trade off was if the hospital wanted the additional trauma business, they had to take all comers, and their reimbursement, in exchange for essentially a monopoly. I have not read anything to indicate that provision has changed. Have you? If so where is it contained?
My understanding is UPMC will accept highmark after 6/13 but highmark will treat it as an out of network provider and the patient will be responsible for additional costs accordingly.
teabagger elite

Erie, PA

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#11
Aug 30, 2011
 

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haha wrote:
<quoted text>
My understanding is UPMC will accept highmark after 6/13 but highmark will treat it as an out of network provider and the patient will be responsible for additional costs accordingly.
Wow! You know everything. You would be a great addition to our organization. Come on down to dc and we'll put you on the payroll asap.
haha

Erie, PA

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#12
Aug 30, 2011
 

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teabagger elite wrote:
<quoted text>Wow! You know everything. You would be a great addition to our organization. Come on down to dc and we'll put you on the payroll asap.
Mumble mumble WHAT? I can't understand a word you said with my balls in your mouth, Nancy.
Remember, I am a proud Teabagger and you get teabagged!!
Open wide!
Ha ha ha

Since: Apr 09

erie pa

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#13
Sep 6, 2011
 
teabagger elite wrote:
<quoted text>Wow! You know everything. You would be a great addition to our organization. Come on down to dc and we'll put you on the payroll asap.
I have highmark and this is actually what they are saying to there customers .
joe

Dublin, OH

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#14
Sep 6, 2011
 

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Wow, healthcare for profit is great. It's no wonder the rest of the world thinks united statesians are idiots.
M1 Garand

Franklin, PA

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#15
Sep 6, 2011
 

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joe wrote:
Wow, healthcare for profit is great. It's no wonder the rest of the world thinks united statesians are idiots.
You are indescribably f-ing stupid
joe

Dublin, OH

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#16
Sep 6, 2011
 

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STUPID, but great in the sack. Just ask your wife and daughter.
M1 Garand wrote:
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You are indescribably f-ing stupid
M1 Garand

Franklin, PA

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#17
Sep 6, 2011
 
joe wrote:
STUPID, but great in the sack. Just ask your wife and daughter. <quoted text>
Yes they know how you boyfriend loves to sodomize you, night after endless night.
joe

Dublin, OH

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#18
Sep 6, 2011
 
Go smell your wifes chin. Smells Luke my ball bag.
M1 Garand wrote:
<quoted text>
Yes they know how you boyfriend loves to sodomize you, night after endless night.
Jon

Franklin, PA

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#19
Sep 7, 2011
 
joe wrote:
Go smell your wifes chin. Smells Luke my ball bag. <quoted text>
Ladies and Gentleman...the modern face of the demcrap party and the average mentality of the Obama voter
M1 Garand

United States

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#20
Sep 7, 2011
 
I live in a trailer and beat my wife when I'm not molesting the dog.

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