Tenet No Longer Doing Business with Humana

Aug 11, 2016

  1. wehotex
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    Just when I thought that my Humana Gold Plus members were SAFE for the AEP, I read this crap!!

    Below is the e-mail that I received today:


    Dear Agent:

    Tenet Healthcare has notified Humana that as of September 30, 2016, Tenet Healthcare facilities and physicians will no longer be participating in any Humana provider networks. A complete list of Tenet Healthcare facilities can be located at tenethealth.com.

    Humana will notify all affected members about this change, and we’ll use our established processes to ensure that our members and employer groups will continue to have access to quality care. Specifically:

    Humana has an extensive provider network, including many hospitals, physicians, and specialists. The physician finder tool on Humana.com can help members find another provider or hospital.
    The termination of our relationship with Tenet Healthcare will not affect access to emergency room services for emergent care from Tenet Healthcare hospitals for members of Humana.
    Members with certain conditions who are receiving care from Tenet Healthcare providers may continue with their providers through the course of their current treatment if they qualify for continuity of care. For example, women who are receiving obstetric care from a Tenet Healthcare provider will be covered in-network through their postpartum checkups.
    Humana is constantly evaluating its provider network to ensure delivery of efficient, affordable and quality health care for Humana members and clients. We take seriously our responsibility to negotiate provider contracts that balance affordability and member access. We are in active discussions with Tenet Healthcare and are hopeful that we will be able to restore in-network access to these hospitals and physicians for our members in the near future.

    If members have questions, they may call our customer service department from 8 a. m. - 6 p.m. Monday – Friday using the toll-free number on the back of their ID card, or for TTY access, call 711.

    Thank you for being a valued Humana agent. We sincerely appreciate your business and the trust you have placed in us to maintain affordable, quality health care for your clients. If you have questions, pl
     
    wehotex, Aug 11, 2016
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  2. XpressInsurance
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    XpressInsurance Super Genius

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    Every year this happens with one of the carriers, some where in the country. Most likely they will work it out. Humana with the large number of enrollees nationwide & Tenet does not want to lose them. Tenet is just trying to get Humana enrollees to put pressure on Humana to negotiate higher rates.
     
  3. wehotex
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    wehotex Guru

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    I'm hoping that it is the case here.
     
    wehotex, Aug 12, 2016
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  4. vic120
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    Every year this happens to someone, this is one of the reason's why 85% of my apps are Med Supp.

    Not only do I have to help unhappy MA clients that are effected by some maj change with at least one MA in at least one area every AEP,

    I always get enough leads where someone is crying the blues because there agent Sold them MA when they were first eligible and never told them it would change, Now they want the Supp Mary down the block has but they cant qualify
     
    vic120, Aug 12, 2016
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  5. XpressInsurance
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    I have about 50/50 mix of med sup & MAPD, I sell in 48 states, this happens a lot, seems like Florida the most. The Hospitals have proven year after year they can put pressure on the carriers by leveraging the enrollees against the plan. Tenet is one big chain with a lot of hospitals in Humana hot spots.
     
  6. vic120
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    I made the decision to stop pulling leads in Fl Last year. I found I can get leads cheaper and sell deals fairly easy but so many of the clients ( even the Medsupp client's in FL)are time consuming and not worth it.
     
    vic120, Aug 12, 2016
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  7. Midlevel
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    I just have to ask how the hell you keep up with all the different Med Sup and MA plans in 48 States. I am in 1 State and hard enough to look at different counties plans. I understand there is quoting software but you still have to know all the different copays, etc on MAPD and PDP plans.
     
    Midlevel, Aug 12, 2016
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  8. XpressInsurance
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    been selling for longtime, most of the MAPD plans are really similar, & you have to rely on summary of benefits or evidence of coverage documents. Med supplement are same except in MN, WI & MA.
     
  9. vic120
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    Sum of benefits is your friend
     
    vic120, Aug 12, 2016
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  10. policy doctor
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    Tenet was bought out here in Atlanta by another hospital chain. I see they have a few urgent care clinics that might be affected but Humana has set up their own.
     
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