Here's where Prisma Health and UnitedHealthcare negotiations stand after January split

UnitedHealthcare and Prisma Health remain at the negotiation table two months after failing to reach an agreement over a price increase, leaving 58,000 South Carolinian patients disconnected from their healthcare providers.

According to UnitedHealthcare, the insurance company delivered its ninth proposal to Prisma on March 21, which included “additional rate increases on top of what we’ve previously proposed” and that they “remain engaged in discussions.”

“Our latest offer would ensure Prisma is reimbursed at rates that are more than fair and reasonable,” UHC said in a statement. “We hope Prisma finalizes the terms of our proposal or provides a counter that is acceptable and affordable for South Carolinians and the employers we collectively serve.”

The dispute has left patients like Celeste Evans, who sees six doctors at Prisma Health, out-of-network and forced to navigate a maze of healthcare bureaucracy.

Evans, who spoke to the Greenville News in January regarding her experience as a Prisma Health patient left out of network, said that even with her continuation of care letters granted by UHC for her Prisma Health doctors, it still has been difficult.

“They told me ‘You still have to pay out-of-network fees and it’s all payable upfront or we will cancel your appointment,'” Evans said.

She added that her healthcare providers would not bill her claims but asked her to file the claims without giving the necessary billing codes. Evans instead was instructed to call a phone number to request a form, which would be mailed to her. Once she filled out the form and mailed it back, Evans would be given an invoice with the proper code to file.

“This happened with all of my Prisma doctors,” Evans said, who estimates she has spent about 65 hours on the phone back and forth with insurance companies and Prisma providers since February.

The companies have placed the blame on each other since the January split. UHC claims Prisma requested a “nearly 20% price hike," saying if it were to take place, healthcare costs would increase by almost $50 million. UHC also stated Prisma “sought significant rate increases for our Medicare Advantage plans that would have increased health care costs by $16 million.”

Prisma denied the 20% price hike, also stating that the hospital system “has been able to come to agreements with all other major insurance companies negotiated with during the past year, recognizing the increased costs that Prisma Health has incurred – all except UHC. This is just more evidence that Prisma Health is being reasonable, but UHC is not.”

Before January, negotiations reached a boiling point when Prisma filed a lawsuit in August requesting a motion for an injunction. In the lawsuit, Prisma alleged UHC made “inflammatory and inaccurate statements to various media outlets regarding the parties’ private business relationships.”

It also stated, “United’s media statement regarding Prisma’s alleged recent counterproposal was false or materially incorrect, and United intentionally made the statement knowing that it was false or materially incorrect.”

A judge dismissed Prisma’s motion.

Savannah Moss covers Greenville County politics and growth/development. Reach her at smoss@gannett.com or follow her on X @Savmoss.

This article originally appeared on Greenville News: Prisma Health, United Healthcare dispute continues; 58K patients wait