Email from TAMU HR:

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Howdy -

Below is the information we were provided today:

This change not only affects the CommonSpirit Health hospitals, but it also has an impact on certain types of providers such as radiologists, pathologists, anesthesiologists, hospitalists and providers who are employees of CommonSpirit Health. A listing of the hospitals that will no longer be in network can be found here: https://www.bcbstx.com/commonspirit/hospitals.

Our employees, retirees, and their covered dependents, still have access to several in-network hospitals and healthcare facilities throughout the areas served by CommonSpirit Health. Covered members have several ways to find in-network providers, and we highly recommend they verify their provider's status by:

• Visiting the BCBSTX online Provider Finder (note it will take about 24-48 hours from today to update)
• Register for or log in to Blue Access for Members
• Call our dedicated BCBSTX customer service team at 1-866-295-1212, or
• Checking with their provider.

Regarding care for ongoing conditions, members being treated for a disability, acute condition, life-threatening illness, or who are beyond the 24 week of pregnancy and are receiving treatment in accordance with the dictates of medical prudence, may have a Continuity of Care benefit available to them. This means the covered member may still be able to get care at a CommonSpirit Health facility at the in-network level of benefits even after CommonSpirit Health leaves the network. To find out if you qualify for continuity of care, please call our dedicated BCBSTX customer service line at 1-866-295-1212.

There may be more questions that we have not addressed within this email. A listing of commonly asked questions can be found here: https://www.bcbstx.com/commonspirit/your-questions, and may answer many of the questions that will come up.

Thank you,

Ashley Porson | Employee Benefits Representative, Benefit Services
Division of Human Resources and Organizational Effectiveness
1255 TAMU | College Station, Texas 77843-1255
ph. 979.845.7131 | aporson@tamu.edu | employees.tamu.edu
TEXAS A&M UNIVERSITY | Learn about Workday @ Texas A&M

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dubi said:

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Email from TAMU HR:

Quote:

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Howdy -

Below is the information we were provided today:

This change not only affects the CommonSpirit Health hospitals, but it also has an impact on certain types of providers such as radiologists, pathologists, anesthesiologists, hospitalists and providers who are employees of CommonSpirit Health. A listing of the hospitals that will no longer be in network can be found here: https://www.bcbstx.com/commonspirit/hospitals.

Our employees, retirees, and their covered dependents, still have access to several in-network hospitals and healthcare facilities throughout the areas served by CommonSpirit Health. Covered members have several ways to find in-network providers, and we highly recommend they verify their provider's status by:

• Visiting the BCBSTX online Provider Finder (note it will take about 24-48 hours from today to update)
• Register for or log in to Blue Access for Members
• Call our dedicated BCBSTX customer service team at 1-866-295-1212, or
• Checking with their provider.

Regarding care for ongoing conditions, members being treated for a disability, acute condition, life-threatening illness, or who are beyond the 24 week of pregnancy and are receiving treatment in accordance with the dictates of medical prudence, may have a Continuity of Care benefit available to them. This means the covered member may still be able to get care at a CommonSpirit Health facility at the in-network level of benefits even after CommonSpirit Health leaves the network. To find out if you qualify for continuity of care, please call our dedicated BCBSTX customer service line at 1-866-295-1212.

There may be more questions that we have not addressed within this email. A listing of commonly asked questions can be found here: https://www.bcbstx.com/commonspirit/your-questions, and may answer many of the questions that will come up.

Thank you,

Ashley Porson | Employee Benefits Representative, Benefit Services
Division of Human Resources and Organizational Effectiveness
1255 TAMU | College Station, Texas 77843-1255
ph. 979.845.7131 | aporson@tamu.edu | employees.tamu.edu
TEXAS A&M UNIVERSITY | Learn about Workday @ Texas A&M

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Just Wow to all of this. I too hope that everyone can grow up and figure this out. It's not good for our community.

Bryan Radiology became CHI St. Joseph Imaging center. The radiologists may not be employed for Chi, but the facility and services are part of the CHI family

Bryan, TX, December 1, 2017CHI St. Joseph Health Regional Hospital will expand imaging services to eight accessible locations across the Brazos Valley with the addition of a new Diagnostic Imaging Center, formerly Bryan Radiology Associates.

All ER visits are covered by insurance whether they are in network our out of network. If for some reason the patient requires admission, the patient will be transferred to an in network facility unless the patient isn't stable enough for transfer.

So if providers are employees of CHI they are considered "out of network"? From my understanding, all of the providers at CHI primary care clinics Clinics are employees of Common Spirit Health.

gettingitdone said:

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So if providers are employees of CHI they are considered "out of network"? From my understanding, all of the providers at CHI primary care clinics Clinics are employees of Common Spirit Health.

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You need to call your Dr office and ask. BCBSTX said there would be a delay in removing the providers from their website.

gettingitdone said:

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So if providers are employees of CHI they are considered "out of network"? From my understanding, all of the providers at CHI primary care clinics Clinics are employees of Common Spirit Health.

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KidDoc posted this on page 2 of this thread. It was from an email.

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Mark Riggins has sent a letter on behalf of the primary care providers to BCBS that will allow the SJMG PCPs to continue to stay in-network for the insurance. Consequently, patients will be able to continue seeing their PCPs in the clinics without interruption. The specialists will also be able to see patients in the outpatient setting and perform any in-office procedures, and some of our specialists have privileges in outside hospitals as well. Consequently, the specialists will continue to take referrals as previously.

Two of the clinic/facility services that will be affected are labs and imaging. For labs, based on patient insurance, there are options to send patients to CPL, Quest, and Labcorp. Because of the eCW interface with CPL, it is highly encouraged to send patients to CPL so we can get discrete data back into the EHR that will qualify for our quality metrics and be the least disruptive to our regular clinic workflow. We are working through the processes of imaging at this point and will give you more details in the coming week.

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gettingitdone said:

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Bryan Radiology became CHI St. Joseph Imaging center. The radiologists may not be employed for Chi, but the facility and services are part of the CHI family

Bryan, TX, December 1, 2017CHI St. Joseph Health Regional Hospital will expand imaging services to eight accessible locations across the Brazos Valley with the addition of a new Diagnostic Imaging Center, formerly Bryan Radiology Associates.

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I was just clarifying that "technically" Bryan Radiology Associates did not get acquired. Only their imaging center was acquired. BRA still exists as a group of radiologists independent of Chi/St Joes. https://www.bryrad.com/

I've never really understood how all this works. Does this mean basically the Brazos Valley network thing is gone, pretty much?

I'm an A&M employee - which hospitals are in-network in BCS, since apparently St. Jo's isn't anymore?

Remember that this is mostly NOT about BCS, it is about Houston. Sad but true. St Lukes gets paid less than all other hospitals for the same work by BCBS and they are asking to be brought up to par basically. It is the same here in BCS with S&W getting more money for the same exact work relative to St Jo from BCBS and CHI is asking to be treated equally not as a "little brother".

On the other hand I get that BCBS wants to control cost and continue to make a profit and bonus their CEO $150MIL a year.

It is a sticky situation but the ones who suffer are the customers/patients who get stuck with out of network bills and poor access to care.

Justin2010 said:

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I've never really understood how all this works. Does this mean basically the Brazos Valley network thing is gone, pretty much?

I'm an A&M employee - which hospitals are in-network in BCS, since apparently St. Jo's isn't anymore?

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The only other non-CHI hospital is S&W.

doubledog said:

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dubi said:

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Justin2010 said:

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I've never really understood how all this works. Does this mean basically the Brazos Valley network thing is gone, pretty much?

I'm an A&M employee - which hospitals are in-network in BCS, since apparently St. Jo's isn't anymore?

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The only other non-CHI hospital is S&W.

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So let me get this straight...

All BCBSTx covered patients will switch to S&W, which KidDoc tells us is reimbursed more the CHI.

Wow that sounds like a winning strategy for BCBSTx (in the short term)

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Exactly. Now BCBSTX has to pay more for exactly the same care! Maybe this was St Joe's strategy....

KidDoc said:

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Remember our part in this deal is tiny relative to the Houston market. This is 100% about the Houston St Lukes vs Memorial and other groups much more than S&W vs St Jo.

Our market is sadly collateral damage in this bargaining.


This is my opinion of course but I am pretty involved with St Jo so I'm not just making stuff up on the fly.

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Appreciate the insight, does KBTX know? and if so why do they not report that fact?

doubledog said:

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KidDoc said:

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Remember our part in this deal is tiny relative to the Houston market. This is 100% about the Houston St Lukes vs Memorial and other groups much more than S&W vs St Jo.

Our market is sadly collateral damage in this bargaining.


This is my opinion of course but I am pretty involved with St Jo so I'm not just making stuff up on the fly.

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Appreciate the insight, does KBTX know? and if so why do they not report that fact?

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They did last night on the 6:00 broadcast. They were talking with Dr Lawson who is the head of the "Texas Division" for CHI.

https://www.kbtx.com/2020/12/18/st-joseph-health-leadership-hopeful-that-agreement-can-be-worked-out-with-blue-cross-blue-shield/

According to what HR sent, Physicians Centre is also a local hospital that would still be in network. I don't think it has an ER though.

I don't work for A&M, but my work switched to BCBS for next year.

threecatcorner said:

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According to what HR sent, Physicians Centre is also a local hospital that would still be in network. I don't think it has an ER though.

I don't work for A&M, but my work switched to BCBS for next year.

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They do have an ER hidden in back.

Maybe it's time for TAMUS to find another company besides BCBS to manage our health care plan. I'm not as big a fan of St. Joes as I used to be, but reasonable choice in providers is important.

dubi said:

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threecatcorner said:

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According to what HR sent, Physicians Centre is also a local hospital that would still be in network. I don't think it has an ER though.

I don't work for A&M, but my work switched to BCBS for next year.

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They do have an ER hidden in back.

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I dont know if it still is, but Caprock was also in network (at least their urgent care was, I assume their ER is too)

I haven't had BCBS in almost a year. After i left TAMU, i got on my husbands insurance through United.

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I dont know if it still is, but Caprock was also in network (at least their urgent care was, I assume their ER is too)

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A few months ago Caprock had a few commercials advertising their ER was in network.

Caprock and PC are fine for the little stuff, but go to St Joe or S&W if you are having a heart attack or stroke.

A&M just emailed us the news about BCBS. Web link.

I asked a question earlier regarding CHI providers. I don't know of a single provider at a St. Joseph primary care clinic that isn't a CHI employee. Per this email sent by TAMU, those providers would now be out of network. Would this also include those specialist that are employed as CHI?

I asked a question earlier regarding CHI providers. I don't know of a single provider at a St. Joseph primary care clinic that isn't a CHI employee. Per this email sent by TAMU, those providers would now be out of network. Would this also include those specialist that are employed as CHI?

I

I asked a question earlier regarding CHI providers. I don't know of a single provider at a St. Joseph primary care clinic that isn't a CHI employee. Per this email sent by TAMU, those providers would now be out of network. Would this also include those specialist that are employed as CHI?

Just called my PPO at the Physicians Center. He has sent me to St. Joe in the past. The person I talked to said in the future he'll be sending folks to Scott & White hospital until or unless all this gets resolved. A little less antsy now about the whole thing, but still...

gettingitdone said:

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I asked a question earlier regarding CHI providers. I don't know of a single provider at a St. Joseph primary care clinic that isn't a CHI employee. Per this email sent by TAMU, those providers would now be out of network. Would this also include those specialist that are employed as CHI?

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As stated above, the out of hospital primary care and specialist are St Joe employees but covered by a different BCBSTX contract. That contract is still valid.

Personally I'd still call.