River Park waives out-of-network fees for Blue Cross
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River Park CEO Steve Otto announced this week that HCA will be waiving out-of-network penalties for Blue Cross patients at all of its hospitals in Tennessee through the end of the year. HCA and Blue Cross recently called off negotiations after being unable to work out a contract.
“I’m concerned, and have been concerned, about the continuity of care in our area,” Otto said. “So rather than waive out-of-network penalties month to month, we’re going to waive those penalties through the remainder of the year.”
Otto said the decision will have a major impact on county residents due to the prevalence of Blue Cross insurance in this area.
“About 75 to 80 percent of the commercially insured people in Warren County have Blue Cross,” he said. “That’s why it’s so huge to this area. So we feel if we go ahead and waive these penalties that it will at least offer some relief locally and allow everyone to sit back and explore their options and alternatives and still have access to health care.”
When contacted yesterday, Blue Cross spokesman Bill Steverson said HCA had not yet informed Blue Cross of its intentions, but that his company would consider it a positive move.
“We have not had any notification of that from HCA,” Steverson said. “But if that’s the case we’re delighted. This whole thing has been about affordability. So I would say that’s a very positive move and I think it’ll help both of us and maybe help us get something resolved in the long term.”
Otto said River Park, and parent corporation HCA, will be absorbing the cost of Blue Cross out-of-network penalties, so that patients will essentially be paying the same rate they would pay if they were still in network.
Otto says the cost of waiving these penalties will be substantial. For example, a patient with a $250 deductible and a 10 percent coinsurance who had a three-day surgical stay for a total hysterectomy at a cost of $11,250 would have a total out-of-pocket charge of $742.50 after Blue Cross payments.
The same patient would incur an out-of-pocket charge of $2,650 for the same procedure according to current Blue Cross out-of-network pay schedules. Once adjusted to reflect the difference between the out-of-network and in-network costs, River Park would wind up absorbing $1,907.
The only situation where a patient might have to pay more is if they visit an in-network Blue Cross facility after a visit at River Park. Since Blue Cross requires both an in-network deductible and an out-of-network deductible, in that case the patient would have to pay both deductibles.
Otto also pointed out that a small percentage of MediCare patients, around 5 percent, mostly retirees with a company-supplied plan that involves Blue Cross, may wind up paying a bit more. For more information on that and other issues, patients can call 815-4207, 815-4107 or 815-4202.