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Bad News For Kelsey Patients Using BCBS

Bad News For Kelsey Patients Using BCBS

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by: PearlandDotCom Active Indicator LED Icon 8 Site Admin  OP 
~ 7 years ago   Jul 27, '16 2:18pm  
Bad News For Kelsey Patients Using BCBS
 
Kelsey-Seybold will no longer be an in-network provider for patients using Blue Cross Blue Shield (BCBS) insurance starting in October.
 
Angela, a Kelsey-Seybold patient, received a major shock this morning when she called to schedule an appointment with her Podiatrist. The operator informed her that come October, her insurance plan would no longer be accepted by Kelsey-Seybold. Angela then decided to call BCBS to get some answers. “She (BCBS agent) told me they could not come to an agreement on the contract,” said Angela. “That means, as of 10/1/16, I cannot see any doctors with Kelsey if I want to be covered…My plan does not offer any out-of-network benefits.”
 
We reached out to both Kelsey-Seybold and BCBSTX, and here are their responses...
 
From Kelsey-Seybold:
 
*BCBS has terminated and dismissed Kelsey-Seybold from the PPO/POS and Traditional/PAR Plan networks. This means effective Oct. 1, 2016, we will no longer be an in-network provider for these plans. This is very disappointing to Kelsey-Seybold and our patients. We have made a long and diligent effort to continue our participation with Blue Cross. We deeply appreciate the trust which our patients have placed in us. We pledge to work with them through this transition , and hope that they will continue to choose Kelsey-Seybold for their care. Blue Cross Blue Shield patients can refer to the link below for more information about this termination and options available to continue their care with Kelsey-Seybold. ~Spencer Berthelsen, M.D., F.A.C.P., managing director of Kelsey-Seybold Clinic*
 
www.kelsey-seybold.c om/insurance/bcbs/pa ges/default.aspx
 
From Blue Cross Blue Shield of Texas:
 
*Blue Cross and Blue Shield of Texas (BCBSTX) have been in contract discussions with Kelsey-Seybold Clinic. While negotiations were held in good faith, we were not able to reach an agreement, therefore Kelsey-Seybold will leave the BCBSTX BlueChoice® PPO/POS and Traditional/Par Plan networks effective Oct. 1, 2016. At the rates Kelsey-Seybold is currently receiving, our members bear the burden of unnecessary and unwarranted additional out-of-pocket costs with no guarantee of a better member experience. Because holding costs down for our Texas members is a priority for us, the rates currently in place at Kelsey Seybold Clinic are not sustainable. We monitor our contracts closely to ensure we offer competitive rates to health care providers that also help keep premiums affordable for our members. Our members expect us to be a good steward of their health insurance premium dollars and to do what we can to help prevent medical cost increases. Health care is a major expense for most families, and we owe it to our members to do everything we can to keep prices down. Even though Kelsey Seybold has made the decision to leave the BCBSTX BlueChoice® PPO/POS and Traditional/Par Plan networks, members still have access to a broad network of participating providers.*
 
www.bcbstx.com/kelse yseybold/index.html
 
Angela went on to add, "I am shocked to say the least! What do you do? Change all the doctors you have grown to trust over the years, or change the insurance coverage you have had for 15 years? What is more important? Your trusted physicians or the people you pay for the coverage? I believe it’s the former, but to change insurance plans is not that easy either. If I don’t change, I will now have only two months to find 13 new doctors and specialists for my family and I."
 
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Suem1223 Active Indicator LED Icon  New Member
~ 7 years ago   Jul 27, '16 5:36pm  
Thanks, Obamacare. Another resounding success.
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MarmaladeRiver Active Indicator LED Icon 1
~ 7 years ago   Jul 29, '16 3:55pm  
As a retired teacher from out of state, part of my insurance costs are covered as part of my retirement package, so I'm stuck with BCBS. I have been repeatedly blindsided by doctors and other medical services dropping them or being dropped by them. It's less critical now that I'm on Medicare, but still a problem. Bummer. I like the doctor I have now but I'm probably going to have to change.
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Stealth83 Active Indicator LED Icon 7
~ 7 years ago   Jul 30, '16 11:46am  
Removed By Request
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MarmaladeRiver Active Indicator LED Icon 1
~ 7 years ago   Jul 30, '16 4:11pm  
@Stealth83 This makes a lot of sense. We often don't realize what a small profit margin many businesses operate on, and that is increasingly including insurance companies. We are quick to think that the only reason prices go up is because companies are greedy, but often it is because their choice is between raising prices and going out of business. Thanks for giving us something to think about.
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patriffel Active Indicator LED Icon  New Member
~ 7 years ago   Aug 1, '16 12:30pm  
First it was Aetna and now BC/BS if this Kelsey's way to force us into KELSEY CARE?
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mommajo Active Indicator LED Icon 1
~ 7 years ago   Aug 1, '16 5:58pm  
@PearlandDotCom This happened to Harris County a few years ago. Kelsey would no longer accept Aetna. We had so many that were upset because most of Harris County employees had used Kelsey for years. It was a big transition for many people!
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Stealth83 Active Indicator LED Icon 7
~ 7 years ago   Aug 1, '16 6:19pm  
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