Cigna, Saint Raphael’s reach agreement

Cigna and St. Raphael’s Hospital are together again.

After their previous contract expired on Oct. 19, St. Raphael’s Hospital and the health insurance provider Cigna announced Tuesday that they reached a new contract agreement. Under the new agreement, patients with Cigna insurance receive in-network benefits at St. Raphael’s, Cigna spokewoman Amy Turkington said. The new contract signifies the end of the a period during which many St. Raphael’s patients were uncertain whether they would be abile to continue treatment at the hospital.

“We are pleased to have reached this agreement because it ensures that Cigna customers will have in-network access to medical care at St. Raphael facilities,” St. Raphael’s president and CEO Christopher O’Connor said in a Tuesday press release.

The two corporations had been negotiating a contract renewal since the summer. When it expired on Oct. 19, they still had not reached an agreement, forcing some St. Raphael’s patients insured by Cigna to either pay higher out-of-network fees or choose a different healthcare provider. The expiration of the contract did not apply to patients receiving emergency department care, those receiving most behavioral health services and some patients undergoing treatment.

Cigna, based in Bloomingfield, Conn., is one of the top five payers to the St. Raphael Healthcare System, the hospital’s parent company, so the expiration affected a large population of hospital-goers. In the press release, O’Connor recognized the inconvenience created by the delay of the agreement.

“We recognize that the process to renew our agreement has been stressful for some patients and we appreciate their loyalty and support,” he said in the release.

Kathryn Ciak, a local Cigna policyholder under the insurance company’s “continuity of care” program, was adversely affected by the negotiations. At the time the St. Raphael’s-Cigna contract expired in October, she was enrolled in a six-month weight loss program at the hospital, after which she was scheduled for a bypass surgery. Her surgery, to be covered by Cigna, was scheduled for Nov. 19. The day before the contract expired, she said, she finished the program only to be informed that Cigna would no longer cover the operation.

Ciak decided to switch to Yale-New Haven Hospital, where Cigna would cover the $25,000 surgery. Still, as a result of the switch, she said, she had to undergo testing all over again — the cost of which she had to cover herself.

“[The agreement delay] is just really inconvenient for someone who is currently enrolled in their programs,” Ciak said. “It’s a little frustrating. You are ready to go and then they change things.”

When contacted by the News Thursday night, Ciak did not know about the contract renewal, and said she was surprised that she did not receive a letter or an email from the insurance company announcing the renewal of their relationship with St. Raphael’s.

Although the details of the new contract are confidential, O’Connor said that the new agreement provides patients with the comprehensive services offered at St. Raphael’s at market-competitive rates that will fairly reimburse the hospital.

St. Raphael’s is the fourth largest hospital in Connecticut.

Comments

  • joey00

    Will YNHH take the debt that St.Raphael’s has ? How about the outstanding patient bills ?
    Will the panhandlers,muggers,drug dealers and the problems that arise from them be resolved before or after the take over ? Were the authorities dragging their feet on that hospital ? I tell you one thing,they are a bunch of very nervous nortons at St.Raphael’s,rightfully so as Yale shows no mercy,drives a hard bargain and will have an agenda,restructering is inevitable. Pity because the ethical good workers are out the door first,the ones that lie and cheat are at the feet of new master – I know first hand how it’s unfolding,people will show their true colors,heads being placed on the block by co workers,slander and mistreatment of patients has commenced to impress overlord now