As of September 1, 2014, UniNet and affiliated CHI Health hospitals and Omaha clinics are out-of-network providers for patients with Blue Cross and Blue Shield commercial health plans. We remain out-of-network for 2015.
Blue Cross plans from every state are affected. However, CHI Health hospitals and providers in Iowa remain in-network for all Blue Cross plans. Physicians in Lincoln remain in-network.
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.
Out-of-network does not mean out of the community. We continue to serve patients in Nebraska and Iowa.
What this means for Blue Cross members:
Blue Cross determines the allowed amount that it will pay out-of-network providers and usually imposes different copayments/coinsurance/deductible amounts for out-of-network providers.
CHI Health is expected to bill the patient to be reimbursed the balance of its full charges.
Blue Cross members can talk to their employer about alternate health plans that include UniNet/CHI Health providers. Our hospitals and physicians are on all other major health plans, including Aetna/Coventry and UnitedHealthcare.
To learn about options to continue seeing your preferred CHI Health provider, call 888-245-4442 or email firstname.lastname@example.org.
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.
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.
We stand committed to three important principles:
Patient Safety: If you or a loved one has a medical emergency, like a severe injury or illness, time is critical. An emergency department is the best place to go - you should always go to the closest emergency department, including those within CHI Health. Emergency care is always covered. If you are a Blue Cross member and denied coverage for emergency services, CHI Health will help you resolve it on the back end, even waiving the out-of-network cost difference if your claim is denied.
Patient Choice: When patients sign up for a health plan, they expect a full network of providers. Patient choice is restricted if an insurance company fails to contract with an adequate network of providers.
Value-based Care: We will continue to focus our care delivery around health and wellness, around superior outcomes that prevent further treatment when possible, and around proactively helping our communities stay well.
Continuity of Care
The Continuity of Care protections that families have relied upon to receive care with their CHI Health provider and/or at their CHI Health hospital may be a short-term solution to a long-term problem. CHI Health will continue to ensure people can still see their CHI Health provider for the services that they need.
Regrettably, there are few protections that CHI Health can enforce when Continuity of Care agreements terminate. Given that, one solution is for Blue Cross members to tell their employers they want a new employee health plan. While employers consider those requests, we recommend that individuals:
Request that Blue Cross reconsider Continuity of Care benefits. Contact Blue Cross to request a reconsideration of their denial. In their letter, patients’ should discuss how they feel about the inability to receive continuing access to their CHI Health hospital at a critical point in their care, and formally ask that their Continuity of Care agreement be reinstated. Requests should be mailed to Blue Cross at 1919 Aksarben Drive, P.O. Box 3248, Omaha, NE 68180. Download a letter template here
Share a Copy of their Request with Their Employer. Individuals formally requesting a reconsideration of Blue Cross’ decision to terminate a Continuity of Care agreement should share a copy of their letter with their employer or inform their employer of their request.
Contact CHI Health to Learn About Possible Cost Relief. Individuals terminated from a Continuity of Care agreement by Blue Cross should call the CHI Health Helpline at 1-888-245-4442 to discuss options for continuing care with your CHI Health provider or hospital and qualifying for financial assistance.