“We are working on plans to help people with Blue Cross Blue Shield of Georgia insurance continue to get the care they need at Polk Medical Center, despite Blue Cross Blue Shield’s decision to exclude Polk from its network,” said Teresa Prevost, Director of Managed Care. “For emergency treatment, even though Blue Cross is now out-of-network, patients can still come to PMC to be cared for and their out-of-pocket expenses should remain the same. Scheduled outpatient procedures will need to be arranged on a case-by-case basis.”
The organization is also alerting Polk County physicians and local employers to this change. Floyd successfully extended its contracts with other major insurance companies to cover Polk Medical Center, but Blue Cross Blue Shield refused. As a result of Blue Cross’ lack of cooperation, people with Blue Cross insurance coverage will now access Polk Medical Center on an out-of-network basis.
The Blue Cross Blue Shield contract with Polk Medical Center ended On April 1, since that facility changed its affiliation and is no longer covered under the master agreement negotiated between HCA, parent company of Redmond Regional Medical Center, and Blue Cross.
“It is important to us that the families in Polk County know that, despite this tactic by Blue Cross Blue Shield, they can still receive treatment at both Polk Medical Center and at Floyd Medical Center,” Prevost said. “Unfortunately, Blue Cross Blue Shield will not consider Polk Medical Center as an in-network facility at this time and may try to put our patients in the middle and cause them to pay more out-of-pocket for using their hometown hospital.”
Floyd officials expected to amend our current Floyd Medical Center agreement to cover care provided at its partner, Polk Medical Center, but Blue Cross insists that Floyd accept the HCA-negotiated contract, rather than simply add Polk to their existing contract with Floyd. HCA no longer has a role at Polk, and it is Floyd’s and Polk’s competitor.
“A new contract is required,” said Prevost. “Blue Cross has been unreasonable in its handling of the Polk contract as well as with ongoing issues with the existing Floyd contract.
"Since Polk no longer has a valid contract with HCA, Floyd now operates Polk Medical Center, and Floyd has a contract with Blue Cross, this demand makes no sense to us. We didn’t ask for an increase in rates or change in rate contract language, just a simple amendment to add Polk to the existing Floyd contract, which is standard practice and the same thing HCA did during its relationship with Polk; Blue Cross then opened the door to a host of issues. This is all the more puzzling since the Blue Cross contract with Redmond expires May 1st, and physicians have just been notified that Redmond /HCA terminated its agreement with Blue Cross effective May 1st.”
Floyd is continuing conversations with Blue Cross Blue Shield of Georgia to have Polk Medical Center covered as an in-network provider.
Individuals with questions or concerns may call Prevost at 706-509-3279 or email at firstname.lastname@example.org.