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Blue Shield of California announced Friday that Stanford Health Care would no longer be included in its network amid contract disagreements.
The decision went into effect on June 29 before the announcement was made, a Blue Shield press release says. However, Stanford Medicine said it plans to honor Blue Shield insurance pricing for current patients during the pending negotiations.
If the contract disputes aren’t resolved, Stanford Health Care Medical Center, Lucile Packard Children’s Hospital and Stanford Health Care Tri-Valley would no longer be covered by Blue Shield, the company says.
“Blue Shield recognizes the challenges of the rising cost of health care, and we negotiate on behalf of our members and customers to achieve our mutual goal of reasonably priced health coverage,” wrote Patty Gonzalez, vice president of network management at Blue Shield, in a written statement.
Instead, the insurance company recommends new patients consider other in-network hospitals like UCSF Benioff Children’s Hospitals, UCSF Medical Center, Good Samaritan Hospital and O’Connor Hospital.
Stanford Medicine and Blue Shield continue to negotiate the contract and hope to come to an agreement soon, Gonzalez wrote.
“Whether or not a new agreement will be reached, Stanford Health Care and Stanford Medicine Children’s Health will continue to welcome all Blue Shield of California patients and will honor Blue Shield’s in-network out-of-pocket expenses for all services and care at our facilities,” wrote Lisa Kim, Stanford Medicine media representative, in a statement.
Kim said patients should not experience disruptions to their care, a policy that Stanford adopted in order to ensure patients don’t experience disruptions to their care, according to a new FAQ page.
Blue Shield also has a Continuity of Care program, which allows certain patients to continue with a doctor or treatment plan throughout policy and network changes. Among other conditions, patients with terminal illnesses, in need of surgery or using pregnancy and postpartum services qualify for continued care, Gonzalez said.
A representative from Blue Shield said that Stanford’s claims that it will continue in-network billing are not accurate and only its Continuity of Care program would allow patients to continue with current pricing.
”Blue Shield is reaching out to Stanford regarding its statements,” wrote media representative for Blue Shield Mark Seelig, in a statement to this publication. “Unfortunately, the information posted by Stanford is not accurate and is causing confusion for Blue Shield members.”
In response to Blue Shield’s concerns, Kim said Stanford’s statement stands and it maintains the information on its website is accurate.
This shows more of the insanity of corporate healthcare in the US. California needs universal healthcare.
I’m still traumatized from having Blue cross / Blue Shield in 2014 though my employer, luckily I was laid off shortly afterward, and had Cigna next.. Not only did they BCBS have a phantom network of no providers if you had the Blue cross plan, but the customer service representatives couldn’t even tell you which providers were in network or out of network between the two “separate” companies. Didn’t even know I was only Blue cross because the card I received had both names. I think its safe to say the “confusion” is due to Blue Shield.