Portneuf hospital, Regence split leaves patients out of network
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POCATELLO — A major insurance provider ended its contract with the largest hospital in southeastern Idaho.
In a Monday afternoon news release, Portneuf Health announced that it is now out of network with Regence BlueShield of Idaho. The contract expired on June 15 after months of “good faith negotiations.”
The dispute revolves around several issues. Officials explain in the news release that Regence routinely denies a substantial portion of claims for medically necessary care provided to patients covered by their plans and has millions of dollars in unpaid claims owed to Portneuf.
The hospital alleges Regence reimburses “substantially less” than other major insurers, causing administrative burdens on the hospital. It argues that a new agreement was necessary to support long-term sustainability.
Regence has not put out an equivalent news release on the contract ending, and couldn’t be immediately reached for comment.
Regence’s position, according to Portneuf Health, is that patients covered by their plans can seek care outside their community rather than reaching a fair agreement with local providers. It claims that Portneuf Health’s parent company, Ardent Health, was asking for “double-digit increases in reimbursement rates,” which they said would force them to raise premiums and out-of-pocket costs.
“Significant issues remain unresolved,” the release says. “Portneuf continues to actively work toward a resolution that ensures patients can access high-quality care close to home.”
Portneuf Health “remains engaged in discussions and will continue working to reach an agreement.”
Although the contract with Regence ended, emergency services are still covered at in-network benefit levels.
Some patients may qualify for continuity of care protections and should contact Regence at 1-888-675-6570 for details. Visit the website for more information.