Insurance Plan Termination FAQ

It is routine for healthcare providers and insurance payers to negotiate and renegotiate reimbursement rates. As costs of healthcare rise, it has become more important than ever for healthcare organizations to be fairly paid for the services they provide so they can continue to deliver the high-quality care patients expect and deserve. Some payers pay the health system significantly less than what they pay other healthcare organizations in our market. We continually work with insurance providers to receive comparable rates to local peer institutions that cover the costs of providing care.

Sometimes, agreement between provider organizations and payers cannot be reached. In these cases, if reimbursement rates for medical services do not cover the costs of providing care, we must terminate the relationship with the payer. It is never what we want. Our top priority is to provide patients with the best care. We make every effort to maintain strong partnerships with all insurance providers to ensure you can get the care you need.

We take insurance negotiations and potential contract terminations very seriously, understanding the impact they can have on our patients. To prevent disruptions in your care, we work diligently to negotiate with insurance companies, often through multiple meetings over many months. When challenges arise, we communicate with employers whose workforces would be affected by a potential termination. By involving employers in conversations with insurance companies, we aim to encourage insurance companies to reach a successful, fair agreement that keeps your coverage intact. Terminating a contract is a last resort. We only consider this option after we have explored and exhausted every possible solution with an insurance company. Our primary goal is to ensure you continue to receive exceptional care at an affordable, fair cost.

If the health system must terminate a contract with your insurance carrier, your provider at the health system would no longer be considered in-network for your plan. You should contact your insurance carrier to understand the impact to you. If you consider changing insurance companies, we encourage you to check that your health system provider is in-network for the plan you’re considering.

We are committed to keeping you informed and to ensuring you have access to the care and services you need. If you have questions, our financial advisors are happy to help you. In Kansas City, call 913-588-7850 or email FinancialCounselor@KUMC.edu. In Great Bend, call 620-791-5054 or email GBC-FinancialCounselor@KUMC.edu.

The health system values its relationships with employers throughout the region. We communicate early and consistently with employers when challenges arise during insurance negotiation. Employers can then convey to insurance companies the critical importance of ensuring the region’s leading academic medical center remains in-network for greater Kansas City residents. Your employer shares the health system’s interest in ensuring world-class care is always available to you.

You may want to contact your insurance carrier to ask specific questions about your care. Your carrier will be able to help you choose in-network providers. You may also wish to impress upon your insurance carrier how important it is to you to keep the health system in your network. To do so, please call the number on the back of your insurance card or visit your insurance carrier’s website to find contact information.

We hope you can check for health system providers’ in-network status before making a new choice. You can learn more about the plans for which we are in-network on this page of major commercial plans we accept. We also suggest a variety of questions you might want to ask about any new plan you are considering. Our priority is to ensure you get the best possible care, even if it cannot be with us.

You may explore this, but unfortunately, many complex healthcare needs are unaffordable to most without the support of insurance coverage. In addition, while some patients may be able to self-pay for office visits, any orders a physician may place, such as for labs, imaging or procedures, would not be in-network and could be costly.

If relationships with your insurance plan are terminated, your coverage would continue through the end of the calendar year. We encourage you to speak with your healthcare provider promptly to work together on the right next steps for transitioning your care. We are committed to assisting you in getting the best possible care and outcomes, even if it can’t be with us.

Call your insurance carrier and ask if you can obtain a Single Case Agreement to continue to have services done at the health system that you cannot have done elsewhere. If you cannot get this agreement, your insurance carrier will refer you to other options.

Our medical records department will be happy to help you. MyChart users can also download many of their records directly. In MyChart, go to the Document Center in the main menu. Follow the prompts to select and download certain visits or click the All Visits tab. You may also submit a form to request a formal copy of your health record by choosing Request Medical Records from the main menu in MyChart.

You can begin by offering your new provider access to your health records through MyChart. Visit the Sharing Hub for options including sending a provider a one-time code for direct MyChart access or by self-downloading records you can send or bring to your new provider. We are also happy to arrange physician-to-physician consults. Your new provider can call 913-588-5862 to begin the process.

Your care team will help support questions regarding your health and future care options, and our customer service team and financial counselors are happy to help you with questions about insurance coverage or billing statements.

For patients in Kansas City, call 913-588-5820, option 2, email FinancialCounselor@KUMC.edu or message us in MyChart. For patients in Great Bend, call 620-791-5054 or email GBC-FinancialCounselor@KUMC.edu.

You can also contact your insurance carrier directly for detailed information about your plan and coverage. At the health system, your health and well-being are our top priority. We are committed to working with your insurance company to ensure you receive the best care possible.

We will always provide lifesaving care in our emergency departments regardless of a patient’s insurance coverage or ability to pay. We believe this is simply the right thing to do, and it’s a legal provision under the Emergency Medical Treatment and Labor Act (EMTALA), which states it is unlawful to delay appropriate medical screening examination or stabilizing medical treatment for any reason.