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Highmark, Coordinated Health, settle dispute

1:48 am by | 0 Comments

deal, agreement

ALLENTOWN, PA - Highmark Inc. and Coordinated Health have settled a nearly four-month-long spat over hospital payments, the two sides announced Wednesday.

The agreement means that patients with Highmark Blue Shield health insurance will be able to get in-network coverage for hospital services at Coordinated Health's Bethlehem Township and South Whitehall Township hospitals.

The new contract began on Tuesday, according to a news release. The announcement said the two sides reached a "multi-year contract," but did not elaborate.

Highmark in September revealed the break with Coordinated Health. During the split, an average patient at Coordinated Health's Bethlehem Township hospital with Highmark insurance would have received perhaps 50 percent reimbursement for services, rather than 80 percent. About 500 Highmark customers had used Coordinated Health's hospital in the township in the year before the break, a Highmark spokesman said at the time.

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The contract between Highmark and Coordinated Health's hospital in South Whitehall expired at the end of last year.

"It is important for our thousands of Highmark members in the Lehigh Valley to have access to these hospitals," said Matthew Vogel, vice president of provider contracting and relations at Highmark Blue Shield. "Access is one of Highmark's key tenets and it is essential to our group customers and members that they have a wide variety of choice when selecting health care providers. Coordinated Health also provides a consistently good value because of the high quality of services at a reasonable cost for our Highmark members."

Coordinated Health specializes in four practice areas -- orthopedics and musculoskeletal care, cardiology, women's health and primary care -- and is among the highest ranked in the state for total joint replacements. It has consistently been chosen as statewide and national leaders in patient satisfaction, quality and cost, the news release said.

"We are very focused on taking excellent care of our patients," Coordinated Health President and CEO Emil DiIorio said. "Highmark is a dominant insurance carrier in the region, and we are very pleased to continue to have its members use our hospitals."

Highmark is the ninth-largest health insurer in the United States. Coordinated Health operates 14 facilities across the region, including the two hospitals, an ambulatory surgical center and walk-in immediate care centers.

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