The HCA Mountain Division leadership issued the following statement on January 5, 2018 regarding the triage and management of Out of Network (OON) patients presenting to our Mountain Star Emergency Departments.
“As we enter the New Year, we want to communicate with our medical staff plans around Out of Network (OON) patients presenting to our Mountain Star Emergency Departments. As many of you may already know, we have been assessing this situation for several months based on concerns for patient safety and quality. We present the following plan of action and communication points:
- Our primary objective is to coordinate a patient’s care based on his/her clinical needs that prompted the emergency room visit.
- Patients requiring inpatient admission for services available at the hospital providing the ER care should NOT be transferred to another hospital based solely on payer source.
- Patients requiring inpatient admission for services not available at the hospital providing the ER care should be transferred to the nearest participating facility providing required services within the patients contracted health plan.
- Potential payment barriers/issues are the responsibility of and will be addressed by the facility CFO and financial counselors.
- Currently there is no change in the instruction for registration for OON payers.
- Any related concerns or questions should be brought to the attention of the hospital CFO for management and resolution.”