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Hospital drops Envision over out-of-network charges — 4 insights

Crescent City, Calif.-based Sutter Coast Hospital will terminate its emergency room services provider contract with Nashville, Tenn.-based Envision Healthcare in 90 days, the Del Norte Triplicate reports.

Here's what you should know:

1. Sutter selected Tacoma, Wash.-based Sound Physicians as its new services provider.

2. Envision Healthcare charged about three times as much as its predecessor, Valley Emergency Physicians, according to Del Norte Healthcare District Chairman Greg Duncan, MD. Several local government bodies have urged Sutter to renegotiate its contract with Envision since November 2016.

3. Earlier this year, Envision was embroiled in controversy over alleged balance-billing practices. After Envision sued Minnetonka, Minn.-based UnitedHealthcare alleging contract violations, UnitedHealth took aim at Envision's emergency room billing practices and dropped plans acquire Envision's ambulatory subsidiary, Nashville-based AmSurg.

4. Sound Physicians has been Sutter's inpatient service provider for more than five years and contracts with nearly every local insurer, Sutter CEO Mitch Hanna said. Sutter and Sound Physicians came to an agreement in late August.

"Patients should not be getting out of network billing from the ER physicians," Mr. Hanna said. "The charge structure is considerably less than the current provider."

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