The Battle Continues Between Blue Cross and Local Doctors - KCBD NewsChannel 11 Lubbock

7/11/07

The Battle Continues Between Blue Cross and Local Doctors

An important alert for those insured by Blue Cross Blue Shield (BCBS), as the insurance provider is apparently no closer to reaching an agreement with Covenant Medical Group.

Last month, we told you the group of 200 doctors said the insurance provider had until September 18th to increase their doctor reimbursements or they would cut ties with them. BCBS says they have no problem increasing reimbursement rates but not to the level the doctors want.

Both sides agree that, no matter what happens, patients will not be out of coverage. However one side says patients may have to pay more for the coverage they're used to, while the other says that isn't necessarily true if a patient switches doctors.

Dr. Scott Robins with Covenant Medical Group said, "We've given them 90 days. At the end of 90 days we'll either have a new contract or we won't and we'll be out of the plan."

While Margaret Jarvis with BCBS says, "Our philosophy is that we should pay doctors in the same specialty, in the same geographic area, who offer the same services the same reimbursement."

The doctors with Covenant Medical Group make up roughly 200 of the nearly 600 doctors that work for Covenant Medical System.

Jarvis said, "What Covenant wants is to be reimbursed at higher rates than other doctors in the same specialty in the area."

Dr. Robins said, "We've been in negotiations with Blue Cross, as we frequently are, about increasing the level of pay or reimbursement they provide us under those plans and they have refused to negotiate."

But according to BCBS, they are willing to negotiate and the two sides of this battle aren't far apart when it comes to a suitable agreement.

Jarvis said, "We're not saying that they should be paid exactly what they want, we're saying that there should be equity and that doctors who practice the same services or the same specialty and are in the same location should be paid the same amount."

Despite this battle one thing both side agrees on is that patients won't be out of medical coverage.

Dr. Robins said, "We will not bar any patients, we will not refuse to see any patients. It's just that Blue Cross's decision might cost the patients more money."

Jarvis said, "Our priority is a plan to smoothly transition the care of our members to the more than 450 physicians in our Blue Choice members who have capacity available."

But BCBS says patients won't pay more if they're willing to change doctors.

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