Blue Cross Blue Shield of Texas members may face high out-of-pocket expenses and confusion after the health insurer broke ties with an emergency room contractor for Arlington-based Texas Health Resources — but not the system's hospitals, according to ABC affiliate WFAA 8.
Effective April 15, contracted ER departments at 14 Texas Health hospitals were no longer in network for BCBS of Texas members, despite being attached to in-network hospitals. The change comes after negotiations failed between BCBS of Texas and ER contractor Texas Medicine Resources, a medical group based in Allen, Texas.
"Hospitals across the nation are hiring outside companies to run their ERs and employ the doctors, nurses and other health professionals you see when you visit the ER. Since these outside companies are not in our network, there are no limits to what their providers charge, potentially resulting in significantly higher out-of-pocket costs," a BCBS letter obtained by WFAA 8 reads. The letter also told members they may receive multiple bills, including one from Texas Health and one from Texas Medicine Resources, if they use emergency services.
In a statement to customers, BCBS of Texas urged members to ensure hospitals are in-network, and in the case of an emergency, noted that, "All plans help pay for medically necessary emergency care services. Go to the nearest hospital or urgent care when you have a true emergency," according to the statement.
More articles on payers:
CEO of Texas health insurer abruptly resigns
UnitedHealth posts $3.5B profit in Q1
Las Vegas hospital doesn't contract with any payers