Negotiations End Between Blue Cross Blue Shield & Covenant Medical Group Doctors - KCBD NewsChannel 11 Lubbock

9/17/07

Negotiations End Between Blue Cross Blue Shield & Covenant Medical Group Doctors

Technically, a contract between Blue Cross Blue Shield of Texas and Covenant Medical Group will end at midnight on Monday, but both sides tell us negotiations are already over.

NewsChannel 11 has been following this dispute since June when Covenant Medical Group doctors requested an increase in reimbursement fees.

Monday afternoon, Blue Cross Blue Shield sent a statement to NewsChannel 11 saying they could not meet Covenant Medical Groups request for a double digit rate increase.

Covenant Medical Group consists of about 200 doctors across the South Plains, and if you are one of their patients, you can either switch doctors or pay higher out of network fees.

NewsChannel 11 caught up with one patient who's already made her decision.

"I'm disappointed because I've had this doctor for four years, and he knows my medical history, and it's going to be hard to find another doctor to replace him," Blue Cross Blue Shield patient Elizabeth Overstreet said.

Overstreet is just one of the 12,000 patients who believes she's ultimately losing in the battle between Covenant Medical Group Doctors and Blue Cross Blue Shield of Texas.

Darren Rogers, the senior vice president at Blue Cross of Texas sent NewsChannel 11 a statement Monday afternoon, it says,

"We regret that Blue Cross and Blue Shield of Texas (BCBSTX) members were put in the middle of issues which needed to be resolved between BCBSTX and Covenant Medical Group (CMG).     Unfortunately, we could not meet CMG's demands for a double-digit rate increase and CMG was unwilling to consider alternatives. Though you've been led to believe we would not come to the table for discussion of any contract changes, the truth is we tried regularly to discuss various contract issues because we recognize the importance of providing our members with a large network of doctors.  Despite the fact that we did not achieve the win-win solution we sought, Blue Cross is still hoping to work with CMG in the future."           

- Darren Rodgers, Senior Vice President, Health Care Management BCBSTX

Dr. Scott Robins with Covenant Medical Group claims that's not true.

"The position Blue Cross has continuously taken is there's been some sort of ongoing negotiation and that's not true. I haven't talked to anyone from Blue Cross about our only issue which is fair reimbursement for six weeks," Robins said.

So, what do you need to do? First, check who your provider is, because if it's not Blue Cross  Blue Shield, your coverage is not affected. Second, call your doctor to see if they're part of the medical group because some group doctors are not.

Robins hopes patients will ultimately be just that - patient.

"Our hope is that our patients will be constant. They will be calm. That they'll wait because according to that (statement) Blue Cross wants us back in the plan and we'd like to be back in the plan," Robins said.

Overstreet says she refuses to be a pawn and is at peace with her decision to switch. 

"I don't want to have to switch back and forth. I want to be able to stay with the doctor that I can stay with for the rest of my life," Overstreet said.

Starting Friday, Blue Cross members will also lose benefits at rural health clinics in Levelland and Plainview, but it's important to note that these changes will not affect Covenant Hospital, so ER visits, lab tests, and x-rays will still be covered.

Covenant has set up a hotline to take your questions, so you can give them a call at (806)725-6543. You can also call Blue Cross with questions. The number you need to call is on the back of your Blue Cross ID card. That will connect you to the center assigned to your plan.

Covenant Medical Group Physicians
Here is a list of Covenant Medical Group doctors who are impacted by the Blue Cross contract as shown on their website. (You will need Adobe Acrobat to open this file)
 

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