Bupa has upped the ante in its dispute with BMI hospitals by warning that it is likely to cut ties with 24 more of the group's hospitals after the pair failed to agree a contract for next year.
It revealed the hospital network quoted prices 20% higher than another national group.
The health insurer has already explained it will remove 12 of the network's hospitals from its use next month, prompting a series of exchanges between the pair about the decision and a subsequent letter sent by BMI.
Bupa has sought to keep intermediaries and their clients informed about the process with an email from Linda Wallace, head of intermediary sales, explaining its current position and the impact after January 1.
"Following several months of discussion, BMI have requested 2012 prices for treating Bupa members that are over 20% more expensive than at least one other national hospital group, despite in our view offering no better quality or service," Wallace wrote.
"Regrettably, it now appears that we will need to take further steps to reduce our use of BMI hospitals, given what we consider to be their uncompetitive pricing proposals.
"Unfortunately, we see no realistic alternative to this course of action.
"If we had to include all BMI hospitals in our recognised lists, regardless of price, this would completely undermine our ability to negotiate good value on behalf of Bupa members.
"We feel these actions are needed to secure affordable, high-quality hospital arrangements for your clients," she added.
Wallace explained that the original 12 hospitals to be removed from Bupa recognised lists all have "have readily available nearby alternatives where Bupa members can continue to have access to high quality care".
And the provider reiterated that those patients already receiving treatment at BMI hospitals would be unaffected.
It also expects to include some BMI hospitals where alternatives are too inconvenient and a group of outer London hospitals where central London ones would be too expensive.
However it warned that these would be kept under review depending on the out-of-contract rates BMI seeks to charge for access to these hospitals.
The email includes resources for advisers to use to contact their clients and clarify the situation.
The BMI hospitals likely to be removed from 1 January 2012 are:
BMI Alexandra Hospital (With the exception of Cardiology, Cardiothoracic surgery & Neurosurgery)
BMI Beaumont Hospital
BMI Bishops Wood Hospital
BMI Clementine Churchill Hospital
BMI Droitwich Spa Hospital
BMI Duchy Hospital
BMI Esperance Hospital
BMI Fawkham Manor Hospital
BMI Goring Hall Hospital
BMI Hampshire Clinic
BMI Harbour Hospital
BMI Highfield Hospital
BMI Huddersfield Hospital
BMI Manor Hospital
BMI McIndoe Surgical Centre
BMI Mount Alvernia Hospital
BMI Princess Margaret Hospital
BMI Priory Hospital
BMI Sarum Road Hospital
BMI Shelburne Hospital
BMI Shirley Oaks Hospital
BMI Somerfield Hospital
BMI South Cheshire Private Hospital
BMI Woodlands Hospital
The BMI hospitals already announced to be removed from 1 January 2012 are:
BMI Bath Clinic
BMI Castle Consulting Centre
BMI Coombe Wing
BMI Edgbaston Hospital
BMI Foscote Hospital
BMI Gisburne Park Hospital
BMI Lancaster Hospital
BMI Meriden Hospital
BMI Oxford Clinic
BMI Runnymede Hospital
BMI Sefton Hospital
BMI Syon Clinic
