Has anyone heard anything about Scott and White and Blue Cross Blue Shield working out their differences by Oct.1? Will they be out of network?
Blue Cross Blue Shield/Scott and White Question
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Last: 1 mo ago by AgFan247
It is worked out through something like May of 2025. Who knows what happens then...
The extension was to October 1, 2024.
Nothing on either the S&W or BCBS' websites show anything new.
Nothing on either the S&W or BCBS' websites show anything new.
"If you will not fight for right when you can easily win without blood shed; if you will not fight when your victory is sure and not too costly; you may come to the moment when you will have to fight with all the odds against you and only a precarious chance of survival. There may even be a worse case. You may have to fight when there is no hope of victory, because it is better to perish than to live as slaves." - Sir Winston Churchill
Everyone I know with Scott and White is now doctor shopping. Good luck out there.
Why are they doctor shopping?
MadDog73 said:
Why are they doctor shopping?
Because if a deal is not made, all S&W providers will be out of network for TAMU employees with BCBS as of Oct 1.
Got it. Thanks.
I have two appointments in Oct, and yea - I am waiting to see if another extension is coming or not...
I have a procedure scheduled with them for October 11th. I love making decisions between my health or financial ruin over stuff like this.
Not just TAMU employees.MiMi said:MadDog73 said:
Why are they doctor shopping?
Because if a deal is not made, all S&W providers will be out of network for TAMU employees with BCBS as of Oct 1.
I think it's all of BCBS Texas.
Koko Chingo said:
https://www.bswhealth.com/patient-tools/registration-and-billing/blue-cross-blue-shield
This was announced quite a while ago. We all want to know if there are any updates to this announcement.
Nothing new they will post it when it becomes official.
(For A&M). Something that is not new but not really talked about is that on April 30, 2025 the Brazos Valley Network discount for S&W expires. That means co-pays will go up and the co-insurance amount A&M pays for will go down, meaning we are responsible for paying more
I want to say the St Joe's discount also expires but at a later date. Don't quote me in the St. Joe's.
(For A&M). Something that is not new but not really talked about is that on April 30, 2025 the Brazos Valley Network discount for S&W expires. That means co-pays will go up and the co-insurance amount A&M pays for will go down, meaning we are responsible for paying more
I want to say the St Joe's discount also expires but at a later date. Don't quote me in the St. Joe's.
Considering we are less than 2 weeks away from the deadline, there needs to be an announcement sooner rather than later. An agreement (or not) affects a **** ton of people in BCS.
I was told they both expire April 30th, 2025 when I asked during the Health Fair this summer.Koko Chingo said:
Nothing new they will post it when it becomes official.
(For A&M). Something that is not new but not really talked about is that on April 30, 2025 the Brazos Valley Network discount for S&W expires. That means co-pays will go up and the co-insurance amount A&M pays for will go down, meaning we are responsible for paying more
I want to say the St Joe's discount also expires but at a later date. Don't quote me in the St. Joe's.
Yeah, I was told spring of 2025 as well - I think we are all OK for this year and the beginning of next.
BV Network was an effort by TAMU to steer employees to St Joe because their contract prices are a few % less than BSW. BSW used leverage with some political types to cause the Tamu leadership at the time to reverse course. The network discounts will go away because if both systems have access, what use (to Tamu) is the discount? They aren't worried about the employee copays.
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I don't see how the local BSW providers/facilities could survive without BCBS customers. They would lose all of TAMU/System, COB, COCS and Brazos County current employees and retirees. Those are just the ones I know of.
No one can survive without BCBS locally unless concierge practice. They have 60-70% of local private insurance.
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Many local businesses also use BCBS including corporate entities so that's tens of thousands more people.TLIAC said:
I don't see how the local BSW providers/facilities could survive without BCBS customers. They would lose all of TAMU/System, COB, COCS and Brazos County current employees and retirees. Those are just the ones I know of.
"If you will not fight for right when you can easily win without blood shed; if you will not fight when your victory is sure and not too costly; you may come to the moment when you will have to fight with all the odds against you and only a precarious chance of survival. There may even be a worse case. You may have to fight when there is no hope of victory, because it is better to perish than to live as slaves." - Sir Winston Churchill
I'm on Cigna these days, so I don't have a dog in this hunt.
It's a big game of corporate chicken. All the hand wringing in the world won't change it.
It's a big game of corporate chicken. All the hand wringing in the world won't change it.
That's what I figured. I just didn't have the information for local businesses.Rapier108 said:Many local businesses also use BCBS including corporate entities so that's tens of thousands more people.TLIAC said:
I don't see how the local BSW providers/facilities could survive without BCBS customers. They would lose all of TAMU/System, COB, COCS and Brazos County current employees and retirees. Those are just the ones I know of.
We faced this issue with United and BSW as well. It's always been fun...
For those worrying about scheduled procedures, the notices we always got when they dropped out of network with United was that in network pricing would remain in tact for a few additional months for scheduled procedures (not appointments) to ensure patients didn't cancel necessary procedures when weighing cost v health.
For those worrying about scheduled procedures, the notices we always got when they dropped out of network with United was that in network pricing would remain in tact for a few additional months for scheduled procedures (not appointments) to ensure patients didn't cancel necessary procedures when weighing cost v health.
That's the thing - BSW doesn't want the majority of patients they get in the area to suddenly disappear, that would not be good for their business. BCBS wants their customers to be happy and not pursuing other insurance as well.
However, each wants to leverage this event for the maximum bargaining power in negotiations, so they send out letters and emails. Concerned folks call both, putting pressure on them.
A few weeks ago, DirecTV's negotiations with Disney / ESPN broke down. We were without ESPN a couple weeks, and it actually hurt their Monday Night Football ratings by about 11%, which was enough to get both sides back to the table, negotiating in good faith.
The older I get, the less stuff like this gets me worked up, because I know both sides don't want to lose business, but they have to go through the charade.
However, each wants to leverage this event for the maximum bargaining power in negotiations, so they send out letters and emails. Concerned folks call both, putting pressure on them.
A few weeks ago, DirecTV's negotiations with Disney / ESPN broke down. We were without ESPN a couple weeks, and it actually hurt their Monday Night Football ratings by about 11%, which was enough to get both sides back to the table, negotiating in good faith.
The older I get, the less stuff like this gets me worked up, because I know both sides don't want to lose business, but they have to go through the charade.
My suspicion is that BCBS wants rates that are closer to the rates they had with the old S&W. When they hooked up with Baylor they started submitting claims on Baylors tax id and getting DFW rates, not historic SE Tx rates. Dallas is one of the most expensive markets in the country for private insurance as far as what they pay hospitals. So moving from SE Tex rates to DFW was detrimental to their bottom line.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Anyone heard anything? Tuesday is the 1st. I might have to find some doctors just like my dentist that became out of network this September.
Zero, zilch, nada, nothing.tb9665 said:
Anyone heard anything?
"If you will not fight for right when you can easily win without blood shed; if you will not fight when your victory is sure and not too costly; you may come to the moment when you will have to fight with all the odds against you and only a precarious chance of survival. There may even be a worse case. You may have to fight when there is no hope of victory, because it is better to perish than to live as slaves." - Sir Winston Churchill
Just got this email:
NEWS ALERT
Baylor Scott & White Health to Stay in BCBSTX Networks
Applies to all groups, Medicare
We're pleased to have reached an agreement with Baylor Scott & White Health that keeps them in our networks and protects our members' and customers' access to quality care at affordable rates. As related documents are finalized, our members will continue receiving uninterrupted, in-network care from BSWH.
NEWS ALERT
Baylor Scott & White Health to Stay in BCBSTX Networks
Applies to all groups, Medicare
We're pleased to have reached an agreement with Baylor Scott & White Health that keeps them in our networks and protects our members' and customers' access to quality care at affordable rates. As related documents are finalized, our members will continue receiving uninterrupted, in-network care from BSWH.
Wonder how many requests for medical records they received in the past couple days
Great news and I'm sure a huge sigh of relief for many!
Shocking!!!! BCBS is 70% of the non government payer market locally - at least. Probably 80%. Of course they reached an agreement. Duh. Patients and employers suffer the most and understand the least these issues. BSW had no ability to suffer any kind of interruption. Why would you give up significant market share voluntarily unless you had a lack of capacity?
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
EBrazosAg said:
Shocking!!!! BCBS is 70% of the non government payer market locally - at least. Probably 80%. Of course they reached an agreement. Duh. Patients and employers suffer the most and understand the least these issues. BSW had no ability to suffer any kind of interruption. Why would you give up significant market share voluntarily unless you had a lack of capacity?
You do recognize that BSWH is one of Texas' largest care provider groups. This wasn't a local thing, but systemwide.
I wish Scott and White would change their website to reflect this.
KBTX must be reading TexAgs again. Just got an alert.
You don't understand the point I was making, but yes. I'm aware. Probably have 30 friends working for them in the Metroplex. Doesn't change the local issues involved. There are others as well - but the S&W rate bump by getting DFW rates was a big one.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.