PHOENIX — Patients insured by BlueCross BlueShield may be at risk of losing in-network insurance coverage at Phoenix Children's healthcare providers at the end of the month.
"Health systems like Phoenix Children’s periodically update agreements with health plans and we are currently in discussions with BlueCross BlueShield about a new agreement," Phoenix Children's said online. "Unfortunately, if an agreement is not reached by October 30, 2024, Phoenix Children’s will no longer be a contracted in-network provider with BlueCross BlueShield after such date."
If no deal is made, Phoenix Children's hospitals, clinics and urgent care locations would be considered out-of-network with the insurance provider starting Oct. 31, 2024. That means patients would likely have to pay more for healthcare services.
However, the healthcare provider stressed that emergency care would not be impacted by this change. Patients could still receive emergency care at the ER for the same rates as in-network benefits.
Patients in need of ongoing treatment for specific conditions may also qualify for "Continuity of Care" or "Transition of Care" in-network benefits.
Phoenix Children's released the following list of locations that would become out-of-network:
- Phoenix Children’s Hospital – Thomas Campus
- Phoenix Children’s Hospital – Arrowhead Campus
- Phoenix Children’s Medical Group
- Phoenix Children’s Pediatrics
- Phoenix Children’s Urgent Care Centers
The healthcare provider said that they would continue to work with BlueCross BlueShield to reach an agreement, and that they were hopeful care wouldn't be interrupted.
Phoenix Children's sent 12News the following statement:
As Arizona’s only pediatric health system, Phoenix Children’s is proud to provide the highest quality care, in an ever-increasing number of locations – the kind of care that can mean the difference between life and death for a child. We want families to know we have been working on the contract with BlueCross BlueShield since January, with a specific focus on changes needed to better serve all kids. Our position is clear: we are asking BlueCross BlueShield to involve a qualified pediatric healthcare professional before denying services or payment. We are also asking BlueCross BlueShield for fair reimbursement rates that align to the cost of care, comparable with other payers in the market, and a commitment to putting Arizona kids first.
BlueCross BlueShield provided the following statement:
After almost leaving UnitedHealthcare in May of last year, leaving Aetna’s network in the Fall of 2023 for several months, and nearly leaving Cigna’s network in February 2023, we are concerned that PCH may want to go out of network to create leverage.
We were disappointed to receive a letter that they plan to leave the network effective October 31, 2024. We hope that PCH will say YES to the $50 million raise. In the meantime, we are getting kids the care they need.
We are connecting with families to ensure continuity of care at PCH for children currently in treatment or with treatment scheduled, quality alternative care in the area, or even out of state options if that’s what it takes.
BlueCross BlueShield customers can call the customer service number on the back of their insurance cards for more information.
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