Published: Aug. 22, 2003
Updated: Nov. 3, 2004
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By Duke Medicine News and Communications
Note — In September, 2003, the Private Diagnostic Clinic (PDC) and Cigna Healthcare reached an agreement for a new contract that became effective Nov. 1, 2003 and will remain in place until Dec. 31, 2006.
DURHAM, N.C. -- Private Diagnostic Clinic, PLLC (PDC), at Duke University Medical Center has notified CIGNA Healthcare of North Carolina that due to continued low reimbursements for professional services rendered to its members, it will terminate its agreement with the insurance company as of the end of the current contract term, Dec. 31, 2004.
Effective Jan. 1, 2005, the more than 800 physicians who provide care at Duke University Hospital and at the PDC clinics (23 clinics on Duke campus and 39 clinics located throughout North Carolina) will not participate in CIGNA Healthcare of North Carolina's managed care products.
"Under the terms of the current agreement, payments to the PDC have remained substantially below the cost of providing services needed by CIGNA members and well below reimbursement levels from similar insurers," said Paul Newman, executive director of PDC. "PDC has not received a rate increase in several years. We feel it is unreasonable for CIGNA not to cover the costs of providing services needed by their members."
The decision of the Private Diagnostic Clinic to terminate the contract with CIGNA does not affect the contract between CIGNA and Duke University Health System, which includes Duke University Hospital, Durham Regional Hospital, Raleigh Community Hospital, Duke University Affiliated Physicians, James E. Davis Ambulatory Surgical Center and Duke Health Community Care.
"The Private Diagnostic Clinic is announcing this contract termination at this time (16 months before termination) to ensure that patients served by the PDC will have ample time to select other health plans that will give them continued access to their Duke physicians," says Theodore Pappas, M.D., executive medical director of PDC. "We want to make sure that our patients have access to the same excellent health care that they've received from us in the past."
PDC currently has health insurance contracts with: Aetna, Blue Cross Blue Shield of North Carolina, Healthcare Savings, First Health/CCN, MedCost, One Health Plan, Partners, Private Healthcare Systems, United Healthcare and WellPath.