Vermilion Parish School Board will decide Thursday to give Lafayette Surgical Specialty Hospital 30 days to join United Health Care Network

The School Board has learned that some school employees are being encouraged by Acadiana doctors, who are under the United Health Care Plan, to go to Lafayette Surgical Specialty Hospital (located on Kaliste Saloom) for certain surgical procedures despite knowing the surgical hospital is an out-of-network hospital under the United Health Care Plan.
The surgical hospital is the only Lafayette out-of-network hospital under the United Health Care Plan.
What is said to be occurring is that after a surgical procedure is completed on the patient, United Health Care is sent the bill from the surgical hospital. Because the surgical hospital is an out-of-network hospital, the patient is hit with an $8,000 out-of-network deductible he or she did not expect.
Because it is a specialty hospital, the school board, who is self insured up to $175,000 per claim, is normally hit with a higher bill than a hospital in its network would be.
“Specialty hospital is defrauding some of our employees,” said School Board member Anthony Fontana. “They are telling employees that the hospital will only take what United Health Care Plan offers. Then they go back and send them a bill.”
Fontana, who is a lawyer, explained that he has a client (who does not work for the school system) who first went to Lafayette General Hospital for an injury. The orthopedic surgeon who saw the person in the emergency room discharged the patient and recommended he go to Lafayette Surgical Specialty Hospital, Fontana explained. The hospital is owned by doctors.
That person, who has United Health Care Insurance, was sent a bill for $18,000 from the surgical hospital, Fontana added.
Lloyd Campisi, the school board insurance agent, informed the school insurance committee that United Health Care is in negotiations with the surgical hospital to try to get them into the network.
The School Board is expected to vote tonight to give Campisi 30 days to sign the surgical hospital to its health insurance plan. If the surgical hospital refuses, the school board is expected to take the surgical hospital out of the school’s insurance system altogether. In other words, if a school employee has surgery in the hospital, the school system will not pay anything.
Buffy Domingue is the chief executive officer of the surgical hospital. She was surprised to hear that school employees are getting surprise bills from the hospital.
“We are a physicians owned hospital, and we pride ourselves on providing high quality specialized care,” said Domingue. “We are currently out of network and we are very much in the process of good faith negotiations with United Health Care.”
Domingue said the hospital informs patients before a surgery that the hospital is an out-of-network hospital.
“We explain what the patient’s financial responsibility is going to be before the surgery,” she said. “There should not be any surprises.”
Domingue added that if there are any financial surprises, the hospital should be notified.
Domingue said the surgical hospital wants to be in the United Health Care network and has a proposal on the table with United Health Care. She said she is waiting on United Health Care to respond to their offer.
When asked if she thought United Health Care will notify the surgical hospital within the next 30 days, she had this to say.
“It is our hope to be in the network with United Health Care and this will all be remedied,” said Domingue. “United has the agreement right now. They need to sign it. I hope it happens within the next 30 days.”