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Metroplex, Blue Cross extending contract

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Posted: Saturday, May 28, 2005 12:00 pm | Updated: 3:15 pm, Wed Aug 15, 2012.

By Natalie Younts

Killeen Daily Herald

The Adventist Health System agreed on Friday to extend the termination date of its contract with Blue Cross and Blue Shield of Texas for one more month, for each of the hospitals involved in negotiations, including the Metroplex Health System, said Margaret Jarvis, BCBSTX spokeswoman.

The new deadline for the two entities to reach an agreement on reimbursement rates was extended from midnight on May 31 to June 30, Jarvis said. This is the second deadline extension; the contract was originally set to expire May 14.

We believe there continues to be positive movement toward finalizing our discussions with Adventist Health System, Jarvis said. Therefore, Blue Cross remains optimistic that final agreements will be reached.

In addition to Metroplex, Adventist Health System operations in Texas include Rollins-Brook Community Hospital in Lampasas, as well as medical centers in San Marcos, Fort Worth and Burleson.

Copperas Cove resident Sheila Mitchell, a BCBSTX customer who uses Metroplex, said she was disturbed by the situation.

Im just an ordinary pawn out here being played between Metroplex and Blue Cross, she said.

Mitchell said the organizations should have an arbitrator and should keep patients best interests in mind.

It doesnt say much for the hospital, she said. And if I didnt have to go there, I wouldnt. Because of this.

She said the Killeen area is more than just a military community with TRICARE.

I thought to myself, How can Blue Cross do this to an under-served area? she said.

If an agreement is not reached, after June 30, services received at Metroplex would no longer be paid at in-network benefit rates.

Instead, they would be paid at the out-of-network benefit level, which may mean higher out-of-pocket expenses for Blue Cross members, depending on which health plan members have, Jarvis said.

In some hospital emergency rooms, patients are billed for two services: First, they are billed by the hospital for being seen in the emergency room.

Secondly, they are billed by the doctor who sees them. Metroplex doctors are not employed by the hospital; they are independently contracted.

Doug Bendall, spokesman for Metroplex, said he did not know details of the hospitals billing for emergency room services. He said he did not know if patients were billed for admittance, as well as for seeing a doctor, or how it would change for BCBSTX patients if the doctors did not accept the insurance.

Jarvis said that plans are so widely varied that she could not comment. She also declined to release details regarding the ongoing negotiations.

Bendall released a statement on Friday saying that the Adventist Health System agreed on May 13 to extend the deadline for contract termination with Blue Cross until midnight May 31.

Both parties felt more time was needed to finalize negotiations and new contracts, he said in the statement.

The extension was granted for that reason and we are hopeful to reach an agreement.

When the outcome of the negotiations is finalized, we will make that information available.

Jarvis said the deadline extension to June 30 is a good sign.

Obviously, were finding common ground or it wouldnt have jumped to another extension.

Jarvis said that if members have questions about their benefits or their providers participation in the network, they should contact BCBSTX Customer Service Department by calling the customer service number on the back of their ID cards.

Contact Natalie Younts at nyounts@kdhnews.com

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