Blue Cross Blue Shield contract with Memorial Hermann expires Sunday

June 26, 2013 1:32:37 PM PDT
The reimbursement contract between Memorial Hermann and Blue Cross Blue Shield expires on Sunday. If the hospital and insurance company can't come to a deal before that date, it may mean Blue Cross Blue Shield patients will no longer be seen at Hermann facilities or by their doctors unless they want to pay out-of-network benefits.

A spokeswoman for Blue Cross Blue Shield says Blue Cross has been in meetings with representatives from Memorial Hermann all day, but so far, the contract is still set to expire Sunday at midnight.

Linda Ross has suffered from chronic migraines since she was a girl.

"It's like my head wants to explode," Ross said.

The headaches are so bad, she can't run her blueberry farm outside of Cleveland when one strikes. So for the last few years, she's gone to a neurologist and that has helped.

"I had a surgery last year on my neck, and it helped with some of the headaches but it didn't get rid of all of them," Ross said.

The problem is Ross carries Blue Cross Blue Shield insurance and her neurologist is affiliated with Memorial Hermann, and the contract between them expires Sunday at midnight.

"We all know it's about the money. Can we just settle this and think about the patients?" Ross said.

A spokesman for Memorial Hermann had no comment on the negotiations between them and the insurance giant.

But Blue Cross Blue Shield is reaching out to customers by email, and with this web page. It says in part:

"We are disappointed that our longstanding relationship with Memorial Hermann may soon end and it remains our desire to keep the health system as part of the BCBSTX provider network."

In an email to Eyewitness News, Blue Cross says one priority is managing medical costs, hinting that money is at the center of the negotiations between the company and the hospital system.

That's of little comfort to Ross whose next appointment with her neurologist is scheduled for after the current contract lapses.

"We have to go every three months and we have another one scheduled in July," Ross said.

And if the contract is not renewed, Ross will have to find another neurologist, or pay out of pocket, a figurative headache on top of the literal ones.

"It would become another headache," Ross said.

Update: After our story aired on Tuesday, both Blue Cross Blue Shield of Texas and Memorial Hermann made statements regarding physician care. From BCBS of Texas: "We want to assure our members that they can still receive in-network care from their physicians who are affiliated with Memorial Hermann through at least Sept. 30, 2013, even if our contracts with Memorial Hermann end on Sunday at midnight. Physicians will not be out of network on Sunday, just the hospital and their facilities. "

And a Memorial Hermann spokesman emailed, saying in part: "The only contract due to expire on July 1st is with the Memorial Hermann Health System and its small number of employees physicians. Private physicians who support our system and UT Physicians are still contracted with BCBSTX. So patient can see them with no interruption after July 1.."

Memorial Hermann declined to comment on Tuesday. Take ABC13 with you!
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