Brittney Lofthouse – Staff Writer

Exactly two months to the day that the contract between Blue Cross Blue Shield North Carolina and Mission Health Systems ended because the two entities couldn’t agree on fair compensation, a joint statement was released late Tuesday afternoon confirming an agreement had been reached.

“Mission Health and Blue Cross and Blue Shield of North Carolina have entered into an agreement for Mission Health participation in Blue Cross networks effective, Friday, Dec. 15, 2017. Both parties are pleased to reach agreement on the mutual goal of ensuring that the people of Western North Carolina receive the affordable, quality health care that they need.”

This new contract, which has been under negotiation since Mission Health’s contract with BCBS termination on Oct. 5, means that Blue Cross NC customers can resume receiving care at Mission Health facilities and with Mission Health providers on an in-network basis as of Dec. 15. Services and provider visits until then will generally be considered out-of-network.

For the last two months, residents in Western North Carolina insured by Blue Cross Blue Shield have been considered “out of network” of Mission Health System hospitals, including Angel Medical Center and Highlands Cashiers Hospital in Macon County. Because patients have been “out of network” they have had to pay higher prices for care or seek treatment elsewhere.

Since it was announced that the contract would be terminated, Mission had maintained that Blue Cross Blue Shield had offered no increase in a new contract, stating it wanted to cut the contract or keep it the same. Blue Cross maintained Mission has some of the highest fees in the region, and wasn’t entitled to a higher-paying new contract.

While both entities were vocal in why the contract was terminated, no details have been released on what the terms of the new contract will be and where they were able to meet in the middle.

“Details of the contract are confidential therefore we will not be sharing additional details other than what we have shared in our joint statement and our FAQ’s, both BCBS and Mission Health reps said in a statement when asked for additional details regarding the contract.

Mission Health would also not provide additional information or comments from Angel Medical Center President Karen Gorby about the agreement.

Macon County Vice Chair Ronnie Beale said that without knowing the details of agreement, it may be too soon to celebrate.

“We don’t know what the actual details are and that’s important, but this is at least the first step in ensuring that Macon County citizens have health care here at home,” said Beale. “This agreement means that Macon citizens, including myself who just had to travel for surgery, are able to receive the care they need, right here. We hope that that means Mission will continue working to bring back doctors and improve health care in our county.”

While the new terms of the agreement is uncertain, BCBS president Patrick Conway is glad a resolution was reached.

“We are firmly committed to ensuring that our customers have access to high-quality, more affordable health care,” said Patrick Conway, M.D., president and CEO of Blue Cross NC. “We are glad that Mission Health has partnered with us to achieve this goal.”

During the two months BCBS was considered out of network for Mission, many patients found new doctors who accepted BCBS. Large businesses and organizations also switched insurance plans to offer employees insurance that would allow Mission to be considered in-network. The Town of Franklin cancelled their insurance with BCBS in October and switched to MedCost for the town’s 63 employees. However, Macon County announced the same week they would be sticking with BCBS for the county’s 360 employees.

“We are glad to see that BCBS and Mission were able to reach an agreement to ensure that not only Macon County employees, but Macon County families will be able to continue receiving care close to home,” said Macon County Manager Derek Roland.

 

Until Mission Health is officially back in-network on Dec. 15, Blue Cross NC customers can visit bcbsnc.com/findadoctor to locate in-network doctors and hospitals in their area. Blue Cross NC customers in Western North Carolina can also use the following resources:

• To talk to a Blue Cross NC Customer Service professional in-person, visit the Blue Cross NC retail store in Asheville at 1854 Hendersonville Rd., Suite C.

• BCBS customers can also go to urgent care facilities for urgent, non-emergency care, and most independent physicians in the area also participate in the network. To find an urgent care or primary care provider near you, go to bcbsnc.com.

•  In an emergency, Blue Cross NC customers should always go to the nearest hospital. Emergency care is always covered as an in-network benefit. Prior authorization is never required for emergency care.

 

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