![]() ![]() "It's not like we're at an impasse," said Shara McClure, division vice president for health care delivery at Blue Cross and Blue Shield of Texas, "We're continuing to talk, continuing to come back with proposals."Īscension Texas, which includes the Ascension Seton hospitals in Central Texas and Ascension Providence in Waco, declined to answer questions about the negotiations and the impact on its patients. The contract, which was a multiyear contract, runs through Jan. Ascension Seton and Blue Cross and Blue Shield of Texas have been in negotiation since the fall. Hospital systems and insurance companies regularly review contracts prior to renewing them. Read more: Dell Medical School health worker made sure Austin mom wasn't alone in medical crisis Why is this happening? It does not affect Ascension Seton Shoal Creek mental health hospital because of a different contract, but it does affect all clinics attached to the Ascension Seton hospitals. It does not affect most of the 2,400 doctors who are at Ascension Seton hospitals because they have separate contracts with the insurance company, which are not up until May or June, depending on the plan. Davis in Luling, and Ascension Providence in Waco. It affects care at these hospitals and their clinics - Dell Seton, Ascension Seton, Dell Children's, Ascension Seton Southwest, Ascension Seton Northwest., Ascension Seton Hays, Ascension Seton Williamson, Ascension Seton Bastrop, Ascension Seton Smithville, Ascension Seton Highland Lakes in Burnet, Ascension Seton Edgar B. Local hospitals: Here's how Austin-area hospitals rank in new patient safety ratings Which hospitals are included? These differ by plan, but in many cases, the difference in deductibles and out-of-pocket maximums are double, costing families thousands of dollars. In-network verses out of network affects how high the deductible is before insurance begins to pay and it affects your out-of-pocket maximum expenses ― the amount at which after you reach the insurance company begins to pays 100% of the costs. Most people who have Blue Cross and Blue Shield of Texas insurance plans would have to pay out-of-network prices if they chose to go to an Ascension hospital. Learn more: How to pick a Medicare plan: Some advice from Austin-area experts It does not affect Blue Cross and Blue Shield of Texas' Medicare Advantage (HMO) and Medicaid networks. This potential change impacts people who have plans Blue Choice PPO, Blue Essentials, Blue Advantage HMO and Medicare Advantage (PPO). Blue Cross and Blue Shield of Texas is the largest health insurance provider in the state with more than 6 million members. These members include city of Austin employees, University of Texas employees, state employees and people who receive insurance through the Teacher Retirement System. Who is impacted?īlue Cross and Blue Shield of Texas estimates 66,000 of its members accessed care at a Central Texas Ascension hospital last year. Patients receiving care at Ascension hospitals who are insured by Blue Cross and Blue Shield of Texas received a letter this week from Ascension outlining the potential impact. Total number of ED visits who were seen on the previous calendar day who had a visit related to COVID-19 (meets suspected or confirmed definition or presents for COVID diagnostic testing – do not count patients who present for pre-procedure screening).Watch Video: US virus aid add-on aims to end surprise med billsĪscension Texas hospitals might no longer be in-network for people who have Blue Cross and Blue Shield of Texas insurance plans starting Feb.
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