Highmark Commercial Insurance
We learned recently of some confusing and inaccurate messages being delivered to the marketplace about billing of Highmark members by UPMC Hamot and its physicians after the Consent Decree ends on June 30, 2019. Specifically, we have heard of insurance customers being told that Highmark members would not be balance billed if they use UPMC facilities or physicians.
According to Paul Wood, UPMC’s Vice President, Public Relations and Chief Communications Officer, "There is no agreement between UPMC and Highmark regarding payments for out-of-network services. Individuals with Highmark insurance who seek nonemergency care from UPMC Hamot, its physicians or other out-of-network UPMC providers after June 30, 2019 will need to pay for their care in advance. This is how it has worked the last several years for individuals with Highmark insurance in the Greater Pittsburgh Area who have sought nonemergency, out-of-network UPMC care.”
If you have any questions about this matter, please contact your Account Manager.
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