Baylor Scott & White Health has established a website about its negotiations with Blue Cross Blue Shield of Texas to continue in-network coverage.
The plans that are included in this negotiation, according to the website, are Baylor Scott & White’s:
- ParPlan
- Blue Choice PPO
- Blue Essentials
- Blue Advantage HMO
- Blue Premier / High Performance Networks (HPN)
- Blue Cross Medicare Advantage (PPO)
- Blue Cross Medicare Advantage (HMO)
- Managed Medicaid STAR Kids
Baylor Scott & White’s BCBSTX Medicare supplement plans are not included in this negotiation.
This negotiation, according to the website, impacts all Baylor Scott & White locations, “including hospitals, urgent care, imaging centers, ambulatory surgery centers and free-standing clinics”.
The website says “Patients should continue to visit Baylor Scott & White hospitals, facilities, and providers as they normally would through the month of June. If an agreement is not reached by July 1, 2024, Blue Cross and Blue Shield of Texas (BCBSTX) will be considered out of network for care delivered by Baylor Scott & White Health (BSWH) doctors or facilities for most BCSBTX members. This could mean increased costs for BCBSTX patients who want to continue receiving care from a Baylor Scott & White Health facility or provider.”
The website also says “The agreement between Baylor Scott & White Health and BCBSTX currently will end on July 1, 2024. If a new agreement is not reached prior to that date, and if you are unable to obtain a Continuity of Care exception through BCBSTX, services provided after this date will be considered out of network, and your BCBSTX benefits may not cover your care. Baylor Scott & White can assist you in scheduling your visits in advance of July 1, 2024, and we appreciate your flexibility.”
For patients receiving treatment for a special condition on or after the date the agreement ends, the website says “If an agreement is not reached by July 1, 2024, some services may still be covered for a short period of time if they already began and are not yet complete; however, we strongly encourage patients to discuss their care plan with their medical team. Certain patients, including those who are hospitalized or undergoing an active course of treatment before the contract end date, may qualify for Continuity of Care through BCBSTX. If you think you may qualify, call the phone number on the back of your BCBSTX health insurance card today to request a Continuity of Care form and apply.”
For patients who have an elective procedure scheduled at a Baylor Scott & White facility on or after the date the agreement ends, the website says “If an agreement is not reached by July 1, 2024, you will need to obtain a Continuity of Care exception through BCBSTX; Otherwise, services provided after this date will be considered out of network and your out-of-pocket costs may be greater.”
For patients who experience a medical emergency on or after the date the agreement ends, and Baylor Scott & White is out of network, the website says “If you experience a medical emergency, you should always visit the nearest emergency department. BCBSTX will pay for services you receive to evaluate and stabilize an emergency medical condition regardless of whether your care is received from an in-network or out-of-network emergency department.”
Statement from Baylor Scott & White Health:
Baylor Scott & White Health is negotiating a new contract to cover care for patients with Blue Cross and Blue Shield of Texas (BCBSTX) health insurance. Currently, patients with BCBSTX plans have in-network coverage with our providers and facilities, and we are working to reach a new agreement before July 1, 2024, to keep BCBSTX plan holders in-network. Our patients are our top priority, and we are working to minimize any potential disruptions.
For more information, please visit www.BSWHealth.com/BCBSTX