Blue Cross/Blue Shield Texas - St. Joseph CHI = Ending Insurance Coverage

18,849 Views | 146 Replies | Last: 1 mo ago by dubi
MisterShipWreck
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[u
doubledog
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doubledog said:

histag10 said:

Didnt KidDoc or someone else say these negotiations had little to do with BCS and St. Josephs, and more to do with the Houston CHI market?
That is correct. It is all about St. Luke CHI Houston (and its competition).
St. Like has reached an agreement, and so we are good too.

https://www.ktre.com/2021/01/09/st-lukes-health-reaches-agreement-with-blue-cross-blue-shield-texas/
EBrazosAg
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AG
Yes
AggieBarstool
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Quote:

Contract Negotiations Update: CommonSpirit Health and BlueCross & BlueShield of TX

Effective January 8, 2021, CommonSpirit Health and BlueCross and BlueShield of Texas (BCBSTX) have reached an agreement and CommonSpirit Health is now in-network. The parties have agreed to reinstate the current provider contract which includes the CommonSpirit Health hospitals and providers.

Claims incurred during the time period CommonSpirit Health was considered out-of-network (12/17/2020 1/7/2021), will be processed as in-network. The BCBSTX provider finder has been updated to show CommonSpirit hospitals and providers as in-network. Questions regarding the status of a claim should be directed to the dedicated BCBSTX customer service team at 1-866-295-1212.
dubi
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AG
Did TAMUS lose the 10% copay at St Joe hospital with the new contract? And the lower Dr visit copays?
EBrazosAg
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AG
Thats all between TAMU and St Joe. BCBS has no part of it except to process the discounts and claim changes properly. BCBS is a TPA that provides a contracted rate and adjudicates the claims for TAMU self funded health coverage. So while the dispute messed up access to St Joe via contracted rates, nothing about its resolution would effect a "side deal" that TAMU and St Joe would have for copay, coinsurance, etc. BCBS could care less as long as they get their 16% fee (or whatever it is - that's just a guess).
dubi
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AG
Thanks!
 
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