Information Regarding Mission Health and BCBSNC

October 24, 2017

[Sent on behalf of Dr. Hathaway to Regional Hospital CEO’s, please share with your Medical Staff and Leadership Teams]

Dear Colleagues:

We trust you are aware that Mission Health is now out of network with Blue Cross Blue Shield of North Carolina.  We also anticipate that you have had or will receive questions from your BCBS patients regarding the implications of this for them. This email is intended to clarify the impact of this situation.

Top Eight Things You Need to Know re: Out of Network Status for BCBS Patients and Mission Health System:

  1. Background. Background details regarding this situation and other relevant concerns related to patient care can be found at www.StandwithMission.org.
  1. Emergency Care. Emergency department care and subsequent admission (if necessary) are always covered as an in-network benefit.
  1. Continuity of Care. Patients have only until November 19, 2017 at the latest to complete a Continuity of Care (COC) form, available at http://www.standwithmission.org/resources/.  An approved COC form is required for those with ongoing medical conditions (e.g., 2nd or 3rd trimester of pregnancy, active cancer care, certain chronic conditions, etc.) to continue to receive in-network benefits.
  1. Assistance.  Help completing COC forms is available by calling (828) 412-6052, Option 2, 8:00 am -8pm, Monday-Friday, or by meeting with counselors at Mission Health SECU Cancer Center, Room 115, 8 am – 5 pm, Monday-Friday.
  1. Undue Delay.  COC request forms will also be used to request provision of outpatient services for which travel elsewhere would create an undue delay or excessive burden on the patient. Examples include, but are not limited to, specialty services not otherwise available in the region (e.g., Cardiac Surgery, Pediatric Subspecialties, Neurosurgery, etc.) and any services for which there may not be capacity in the region despite limited specialty availability (e.g., Cardiology, Pulmonary, etc.).
  1. Discounts. Prompt pay discounts are being arranged for those who incur out-of-network expenses. Patients can call (828) 412-6052, Option 1 to learn specifics about how they may benefit from this program.
  1. Who Is Impacted? Mission’s out-of-network status applies to all commercially insured BCBS patients and Medicare HMO patients, but not to patients with Medicare supplemental coverage from BCBS who are otherwise unaffected.  Blue Cross Federal employees will remain in network until November 16, 2017.
  1. Transfer requests.  Transfer requests to Mission Hospital from the region should be arranged as usual, by calling Mission Direct at 1-(877)-MISSION (877 647-7466).  Transfers required due to emergency and/or undue delay remain in network.

Regards,

William R. Hathaway, MD, FACC, Chief Medical Officer
Mission Hospital

 

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