Blue Cross Blue Shield of Arizona Ready to Assist Members
Editor's Note: This article is the press release from Blue Cross Blue Shield, expressing their perspective. Read the Press Release from Dignity Health YRMC here.
- YRMC hospital costs are double and triple what we see in other parts of the state
- YRMC’s decision to leave the network does not apply to nearly 80% of Blue Cross Blue Shield's 58,000 covered members in Yavapai County
- Blue Cross Blue Shield considers standing up for members one of the most important things they do
- Blue Cross Blue Shield is working quickly to accommodate patients who have asked for help in finding alternate care settings
- Read more...
BCBS hoped YRMC would meet in the middle and stay in network
“We had every reason to believe that Yavapai Regional Medical Center intended to meet us in the middle and stay in network,” says Pam Kehaly, President and CEO, Blue Cross Blue Shield of Arizona. “Providers should absolutely be paid fairly and honored and respected for their talent, expertise, and compassion. To protect affordability, we all need to make sure that unnecessary increases be kept in check, especially in this case where hospital costs are double and triple what we see in other parts of the state. Because individuals and families can’t negotiate rates directly, we consider standing up for our members one of the most important things we do.”
Yavapai Regional Medical Center’s decision to leave the network does not apply to nearly 80% of our 58,000 covered members in Yavapai County. Emergency care, even at Yavapai Regional Medical Center, is still covered at in-network rates.
Blue Cross Blue Shield of Arizona clinical care teams are making certain that patients can continue scheduled care, surgeries, and inpatient stays that are underway. We are working quickly to accommodate patients who have asked us to help them find alternate care settings and making special arrangements for those patients who may be facing a life altering diagnosis.
“Our number 1 goal is getting our members the care they need,” says Dr. Cara Christ, Chief Medical Officer for Blue Cross Blue Shield of Arizona. “We are responding to each patient who reaches out with questions or needs guidance. Insurance is complicated and it is our job to sort out the details in this type of transition.”
All members in Yavapai County have health insurance regardless of the outcome of the negotiations. Additionally, all members in Yavapai County can go to any emergency room that they need to because emergency services are always covered, regardless of the facility's network status.
Primary care providers at Yavapai Regional Medical Center community clinics remain in network. The YRMC Medical Group Clinic providers have separate agreements and are still in-network.
If a member requires admission from the ER, the inpatient stay may be handled in different ways, depending on the patient's medical circumstances:
- If a member needs more advanced care or treatment than the ER facility can provide, the patient would be transported to another facility that is able to provide the necessary care.
- If YRMC can provide the care, and the patient can be safely transferred to an in-network facility, BCBSAZ will assess the situation and may arrange for the member's transfer at no added cost to the member.
- If YRMC can provide the care, and the patient can't be safely transferred to an in-network facility, the patient will be covered in-network at YRMC.
Our priority and focus is on our members and doing whatever is necessary to get them the care they need.
What members need to know
This negotiation only impacts a small percent of Blue Cross Blue Shield of Arizona members. Most members are not impacted by this negotiation and will be able to continue to access YRMC, even if we are unable to reach an agreement on the contract.
If you fall into the below categories, there is nothing you need to do differently:
- BCBSAZ Health Choice (AHCCCS and DSNP)
- Federal Employee Program (FEP) is not impacted through the end of 2023
- HMO plans using the Neighborhood Network are not impacted through the end of 2023.
- Senior Security Medicare Supplement is not impacted
Here's how to check your Member ID:
- If your member ID begins with “R”, “NNJ”, or “NNG”, “HC”, “MZH” this contract termination does not apply to you.
- If your member ID begins with any other letter combination, this contract termination may apply to you.
After February 8, if your plan uses one of the following networks, Yavapai Regional Medical Center (YRMC) hospital facilities and their hospital-based physician group will be considered out of network.
- PPO or EPO plans using the Statewide/National PPO Network
- HMO plans using the Statewide HMO Network
- Medicare Supplement plans using the Senior Preferred Medicare Supplement Network
- Plans using the BCBSAZ Workers Compensation Network
We're here to help.
Continue your care:
- Emergency care is always covered.
- You can complete in-process treatment and hospital stays as in network.
- For surgeries scheduled, you can continue with your appointment and post-surgery care in network.
YRMC Dedicated Line:
Our Member Service lines are available during business hours.
Call the number on the back of your ID card or reach out to our team below:
Individual & Family Plans:
Medicare Supplement Plans:
Commercial (Employer) Group Plans:
Read this press release here: https://www.azbluefacts.com/yavapai
Read the press release from Dignity Health YRMC: https://copperstate.news/prescott-news/item/2077-yrmc-dignity-and-blue-cross-blue-shield-fail-to-come-to-agreement