Springfield Clinic and Blue Cross-Blue Shield Rift Continues Toward Nov. 15 Deadline

By Benjamin Cox on October 18, 2021 at 9:00am

One of the state’s largest insurance companies and one of Central Illinois’ largest health care providers are still at a rift about in-network coverage.

According to the State Journal-Register, Springfield Clinic sent letters and emails to about 100,000 Blue Cross-Blue Shield of Illinois covered patients who could lose access to their Springfield Clinic doctors on November 17th. The letters criticized BCBS’ record profits earned during the COVID-19 pandemic and said it would adversely impact out-of-pocket medical costs for BCBS patients.

The two entities have been in dispute for half the year over reimbursement rates. Springfield Clinic says on their website that they do not anticipate a resolution with the insurance provider by the November 17th deadline. Clinic officials indicated on the website that contract terms backed by Blue Cross would hurt the clinic financially and make it harder to attract and retain doctors, especially specialists, in central Illinois.

Springfield Clinic officials say in their letter that Blue Cross members are encouraged to consider “self-pay” options and contact the clinic’s patient advocacy center at (217) 391-7086 for assistance.

Officials said patients can continue to see their clinic doctors using out-of-network benefits or contact their employers’ benefit-plan administrators to determine whether they can switch plans and still see clinic providers on an in-network basis.

Patients can call Blue Cross to determine whether their ongoing treatment, for conditions such as pregnancy and cancer, qualifies for “continuity of care” coverage at the same rates after Nov. 17.

Plans not impacted by the rift are Blue Cross-Blue Shield supported Medicare and Medicaid coverage.