WEATHER WATCH
Saint Francis to leave Blue Cross and Blue Shield network
Saint Francis to leave Blue Cross and Blue Shield network (KTUL){p}{/p}

A major shakeup in healthcare as BlueCross and Blue Shield and Saint Francis Health System part ways.  

BCBSOK is currently in a 90-day transition period to allow members time to make decisions about their future care, as Saint Francis will leave BCBSOK networks on July 29th. 

"What we need to do is everybody needs to reach out to Blue Cross and Blue Shield and say this is unacceptable," said 'Lisa.'

Her back is to the camera to protect her identity, and we're calling her Lisa. And she called us after receiving notice that her healthcare choices have been turned upside down.

"I’m stuck in the middle as the subscriber with an entity that’s playing hardball with my health," she said.

Why the break-up? 

Here’s part of the statement BCBS released to us:

"Saint Francis has more than 100 locations, but only four acute care hospitals. It continues to expand, adding clinics and retail locations. It wants us to reimburse many of its clinic and retail locations the same as the acute care hospitals. This would mean our members pay much higher rates for services at off-campus locations operated by Saint Francis. We want to ensure our members receive the right service, at the right place for the right price."

"You have to keep the largest, and in my opinion, premiere network in the Tulsa area in-network," she said.

Lisa is hoping the public outcry will spur officials to reconsider the situation. In the meantime, she has to prepare for either outcome.

"It means that I’ve got to spend hours on the phone, which I already do spend hours on the phone with BCBS customer service and try to fight to get an exception or I’ve got to do homework now and go out and find a list of doctors that specialize in what I need them to do and then find out what is about them and try to get my records transferred and everything else. So it is a lot of work either way I go," she said.

Official Media Statement from BCBSOK:

"After months of negotiation in good faith with Saint Francis Health System, BCBSOK and Saint Francis were unable to reach an agreement that would protect Blue Cross and Blue Shield of Oklahoma members and customers from future cost increases as the hospital system continues to grow and expand.

Saint Francis has more than 100 locations, but only four acute care hospitals. It continues to expand, adding clinics and retail locations. It wants us to reimburse many of its clinic and retail locations the same as the acute care hospitals. This would mean our members pay much higher rates for services at off-campus locations operated by Saint Francis. We want to ensure our members receive the right service, at the right place for the right price.

This is not the outcome we had hoped for, but our networks remain strong and we are committed to helping our members transition to the thousands of other quality, in-network providers in the Tulsa metro and across the state.

As a member-owned health insurer, negotiating physician and hospital contracts is one of the ways BCBSOK protects our members and customers from unnecessary and inappropriate increases in health care costs. While we understand prices go up over time, we must be good stewards of our members' health care dollars to keep out-of-pocket expenses and premiums as reasonable as possible."

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