GHS Medical Center insurance coverage battle 'scaring the hell out of all the patients'

News 12 at 6 o'clock / Wednesday, July 25, 2012

AUGUSTA, Ga. -- Former Mayor Bob Young is not happy with the Georgia Health Sciences Medical Center's plans to cut ties with Blue Cross Blue Shield in a matter of days. They have been negotiating for nine months and have not reached a deal.

"It's just not the way you treat people," said Young, who was shocked to receive a letter telling him of difficult negotiations between his health insurance provider and the Georgia Health Sciences Medical Center. "But the sorry thing is that they have both taken the position of let's scare the hell out of all the patients."

The hospital plans to terminate their contract with Blue Cross Blue Shield. The letter was intended to send a message to patients.

"We're saying there is a situation here and help us," said Frank Smith, chief operating officer of Medical Associates.

Young was less than impressed with the letter that encouraged him to contact BCBS directly.

"And then to send us a letter saying we're going to cut you off and here's the telephone and phone number for Blue Cross Blue Shield," said Young with great indignation. "I don't need to call them. I need to call Chris Thomas."

We stopped by the local Blue Cross Blue Shield office and called the corporate headquarters.

"If this happens, will people just be kicked off the program?" we asked.

"It's not about being kicked off. We have an extensive network of physicians that are throughout the community," said Cheryl Monkhouse with Blue Cross Blue Shield, who notes that both sides have continuity of care provisions.

"If someone is in the middle of a treatment," Smith said, "we'll continue to see them through the logical conclusion of the treatment."

"Lets stop being petty. Lets work this out," Young said. "Somewhere in the middle is the solution."

The medical center and Blue Cross have not negotiated their deal in nine years. The hospital wants more money.

"However, the rate of increase that they are demanding is extraordinary and simply just not sustainable," Monkhouse said.

This accounts for about 10 percent of the medical center's business.

"Can you afford to take this gamble?" we asked Smith.

"We can't afford not to," Smith said.

The two sides now have 10 days to come to an agreement.

"Can you get a deal done in that time?" we asked Smith.

"Yes," Smith said. "I think we can."

Thousands of customers are left hanging in the balance.

"I hope they work it out," Young said. "But you don't send me a letter and tell me I can't see my doctor anymore."

If the two sides can't reach a deal the contract be terminated August 15th.


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