OSF HealthCare released an update Thursday afternoon on how things are progressing regarding talks with insurance companies. Their statement is listed below:
”OSF HealthCare has successfully completed negotiations with a number of insurance companies, including multiple products for commercial members and Medicare and Medicaid beneficiaries. The complete list can be found at https://www.osfhealthcare.org/billing/insurance-plans/insurance-by-hospital/. We continue to engage in discussions with a few other insurance payers to reach mutually beneficial solutions for patients at OSF HealthCare Heart of Mary Medical Center (Urbana) and OSF HealthCare Sacred Heart Medical Center (Danville) including Blue Cross and Blue Shield of Illinois, HealthLink, and Aetna/Coventry.
In regards to negotiations with Blue Cross Blue Shield of Illinois, OSF HealthCare is concerned about their proposal which includes significant differences in the reimbursement level between the Urbana and Danville hospitals with other OSF facilities such as those in Bloomington, Galesburg, Pontiac, Ottawa, and Alton, Illinois. A long term agreement was completed between Blue Cross and OSF shortly before Thanksgiving for hospitals in those markets that have many similarities in demographics and services to those in Urbana/Champaign and Danville. We continue to negotiate with Blue Cross and Blue Shield and have recently provided a counter proposal that we believe is fair and consistent with other OSF facility contracts with Blue Cross and Blue Shield of Illinois as well as other payers in these markets.
If a patient is in active treatment under a physician order with services such as chemotherapy or physical therapy being performed at OSF Sacred Heart or OSF Heart of Mary that began prior to February 1, and has insurance through a payer we don’t yet have a contract with, OSF HealthCare will “benefit match” for the services. This means that even though the facility is currently out of network in the eyes of any payers we are negotiating with, OSF will make the appropriate adjustments so that the patient is only responsible for out of pocket costs that they would incur at an in-network facility. OSF HealthCare is making these adjustments only until an agreement has been completed with payers we are negotiating with and only for patients with a prior active treatment plan that began prior to February 1. If a patient has questions, please call 800-421-5700 for assistance.
OSF HealthCare provides care to all patients who come through our doors, regardless of their ability to pay or mode of payment. We do our best to inform the patient of their financial responsibility and offer a variety of programs to patients who qualify. For people seeking or transported to one of our hospitals for emergency care, by law that care is covered at in-network rates.
Members of those payers where the OSF facilities may be out-of-network should contact their insurance provider to determine their specific benefits available or contact their employer’s human resource department to determine their options. Patients can always use their out-of-network benefit for services at these hospitals.
OSF HealthCare remains hopeful of reaching a positive resolution so we are able to continue to meet the needs of those we’ve been called to serve. We appreciate the desire to have access to our OSF hospitals and to the entire OSF HealthCare system of coordinated care that takes seriously the quality, cost, and experience for each one of our patients.”
