Have You Never Thought About Insurance Claims?

Smoot / Phoenix Staff Writer Apr 6, 2017 Transitioning from EASTAR Health System to Saint Francis Hospital Muskogee proved problematic for some patients insured by Blue Cross Blue Shield of Oklahoma. Problems surfaced after contract negotiations reportedly broke down between the insurer and Saint Francis Health System with regard to reimbursement rates for health care services. BCBS of Oklahoma posted an online alert, notifying its members that two Muskogee hospitals and many of the physicians swept into the Saint Francis network had been removed from its network of providers for seven plans. Saint Francis The Most Recent Updates Concerning Insurance Claims Advice officials issued a statement Wednesday night, saying in-network services at Saint Francis Muskogee Hospital remain available to BCBS of Oklahoma members. They declined to elaborate or explain the contradicting statements. Saint Francis Health System bought EASTARs east campus and assumed the remainder of a 40-year lease for its main campus, a facility that is owned by a city trust formerly known as Muskogee Regional Medical Center. The acquisition by the Tulsa-based network of hospitals, clinics and physicians was announced in February and finalized Saturday. BCBS officials, in the online alert that was removed Wednesday following media inquiries, attributed the problems to a decision made by Saint Francis to reject reimbursement rates previously accepted by EASTAR. That decision resulted with Saint Francis Hospital Muskogee and its physicians being removed from the insurers network of providers, but the situation began to shift Wednesday. At this time, Blue Cross and Blue Shield of Oklahoma is engaged in confidential negotiations with Saint Francis with the intent to protect our members in the Muskogee community, spokeswoman Lauren Cusick said. We are unable to comment further. Saint Francis officials acknowledged in their statement that they continued to be engaged in confidential negotiations but were unable to provide additional information at this time. Local health care consumers began sharing concerns after learning they might have to find new primary care providers or travel to hospitals outside Muskogee to secure in-network savings offered by their insurance plans. Ronnie Ball said he learned about the situation when he went to a scheduled doctors appointment to get a report from lab work that had been done earlier. Ball, who has coverage through the Blue Cross Medicare Advantage PPO plan, said he learned after he arrived his insurance would not be accepted because his physician was no longer considered an in-network provider as a result of the Saint Francis-EASTAR deal. That leaves me … without a local hospital to go to unless I want to risk paying out-of-network costs or maybe having to pay 100 percent of the costs, Ball said.