The Doctors And Insurance Company Cut A Deal - KCBD NewsChannel 11 Lubbock


The Doctors And Insurance Company Cut A Deal

The dispute between Covenant Medical Group (CMG) and several hundred area doctors within the Covenant Health System and Blue Cross Blue Shield (BCBS) started in June of this year.

The doctors wanted increased reimbursement rates while the insurance company said the doctors were already being reimbursed at a rate suitable for this area.

On September 18th the doctor/insurance company relationship dissolved leaving thousands of patients "out of network" and out of luck. Patients were forced to either find a new doctor, switch insurance companies or pay much higher "out of network" rates.

Saturday officials on both sides announced a new deal.

"We couldn't be happier. I think they are very pleased. And I think everybody was very professional and wanted to do the right thing," said Gwen Stafford with Covenant Health System.

Melinda Clark, president and CEO of Covenant Health System, was the catalyst for this new deal. Clark placed a call to BCBS the day after Thanksgiving. Since then the two sides were able to iron out their issues through e-mails and face to face meetings. And early Friday morning the deal was final.

"This is a renewed partnership. You're going to see the medical staff, CMG physicians, BCBS working on quality, efficiency and it's really a very good partnership," said Stafford.

In this new deal, not only are the doctors and the insurance company working together until 2011, but so is the entire Covenant Health System as a whole.

"In West Texas, patient and physician relationships are important especially if you've seen somebody for years and years. So as of today, everybody's in network," added Stafford. 

This is especially good news for patients in Levelland and Plainview who have had to travel to Lubbock for medical care during the past 60 days. Now they can go to the medical facilities in their own areas once again.

In the coming weeks and months, Gwen Stafford says there will be a lot of personal contact between the Covenant Medical Group doctors and the patients they lost when the relationship dissolved in September. The outcome the doctors are looking for? That any patient who left their doctor will return.

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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