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."