A proposal from Blue Cross and Blue Shield of Nebraska that we hoped could bring CHI Health St. Elizabeth back in network offered no progress. The offer was worse than where we ended our negotiations on September 1. As a result, CHI Health hospitals remain out-of-network with Blue Cross and Blue Shield of Nebraska commercial health plans. Blue Cross plans from every state are affected, however, CHI Health hospitals and providers in Iowa remain in-network for all Blue Cross plans. From the proposal that Blue Cross presented to us, it is clear that we could remain out-of-network for a prolonged period of time. Watch the video from CHI Health CEO, Dr. Cliff Robertson for more information.
What you need to know
Your health has to be the top priority. We will continue to keep the costs we, CHI Health, can control the same for you regardless of whether you are in or out of network. So please, do not put off going to your doctor. Get the care you need!
Medicare supplements are not affected. If your primary insurance is Medicare and you have a Blue Cross Medicare supplement plan, you are NOT affected by this issue. Your copays and deductibles are unchanged.
Emergency medical care is covered as in-network. As they always do, Blue Cross will have to verify the care is emergent.
Physicians within The Physician Network are in-network and are not affected.
Blue Cross plans from every state are affected. However, CHI Health hospitals and providers in Iowa remain in-network for all Blue Cross plans.
If you have questions or would like to calculate the cost for your out-of-network care, we have set up a call center to help you.
Please call us at 888-245-4442.
A Blue Cross Update from CEO Dr. Cliff Robertson
CHI Health CEO, Dr. Cliff Robertson, discusses our three areas of continued focus: patients, employers and good faith negotiations.
For questions about your out-of-network costs, call 1-888-245-4442 for an estimate.
What You Can Do
Please talk to your doctor or care provider about your care plan. Patients scheduled for or receiving certain treatments during this out-of-network period may be able to continue their care as planned, at in-network rates. For more information on Continuity of Care benefits, call the phone number on your Blue Cross insurance card.
Consider alternative health plans. Our hospitals and physicians are on all other major health plans, including CoOportunity Health, UnitedHealthcare and Aetna/Coventry. Talk to your employer or broker about your options.
If you have questions or concerns, please call (888) 245-4442.
Background on the Negotiations
Blue Cross routinely refused our proposals and refused to compromise. At the close of our negotiations period, we were left to choose between compromising our quality of care and going out-of-network. We were not willing to jeopardize our quality, break up the clinically integrated network that we've spent years building, or put our patients in danger. As a result, we are now out of network. Please refer to the list below to see which hospitals are affected.
Continuity of Care Benefits through Blue Cross and Blue Shield
Any patient who needs to continue care for a course of treatment beyond Aug. 31 will need to contact their BCBS plan for their respective Continuity of Care Benefits application. For example, if you have Blue Cross Blue Shield of Nebraska, you will need to contact them and request their continuity of care document. To receive Continuity of Care Benefits, both the patient and their physician must complete and sign the form.
The application documents that the patient meets criteria specified by BCBS for continuing their care with the hospital, and the provider agrees to accept the contracted rates as payment in full. Some of the most common conditions that may qualify for Continuity of Care Benefits are included, but not limited to:
Currently undergoing non-surgical treatment for cancer
Currently undergoing surgical treatment for cancer
Currently undergoing active treatment for severe or end–stage renal disease or dialysis
Pregnancy after first trimester
Recent bone marrow or organ transplant or are on the waiting list to obtain an organ
Currently receiving inpatient services at a facility (on the day of termination of contract)
Currently receiving out- or inpatient treatment for mental illness and/or substance abuse by a licensed mental health provider
Currently undergoing active treatment for HIV and AIDS.