More information about Regence and Harrison

A lot of Regence BlueShield customers in Kitsap County are confused and frustrated by the rift between their insurance company and Harrison Medical Center.

They have every right to be. It’s a confusing and frustrating situation.

regence_1418607978483_11097742_ver1.0_640_480Regence and Harrison terminated their contract on Aug. 22 after failing to agree on reimbursement rates. That meant Harrison was no longer “in network” for thousands of Regence BlueShield customers. Those customers would have to pay more out of pocket to receive care from Harrison.

As we reported in December, Regence and Harrison reached an agreement that ensured most Kitsap residents could still access Harrison’s emergency departments at an in-network rate. (Regence determined residents in seven South Kitsap zip codes could use Pierce County hospitals, so they were excluded.)

The agreement was made retroactive to Aug. 22, so anyone who was charged too much for emergency care last fall should get their bill corrected.

The agreement hardly ended the confusion. 

Since the deal was announced I’ve received calls and emails from Regence customers who said they’d talked to Regence representatives and were told emergency care at Harrison was still out of network.

State Sen. Christine Rolfes, who’s been looking into the issue, heard the same from Regence customers. The state Office of the Insurance Commissioner also received inquiries about the Regence/Harrison situation.

Harrison_1406046083914_6990639_ver1.0_640_480Regence spokeswoman Jennifer Morgan said the company sent letters to customers with information on the emergency care agreement on Jan. 6, about a month after the deal was formalized. A copy of the letter is embedded below and posted here.

Morgan said Regence customer service representatives were briefed on the agreement, and no customers should have been told emergency care at Harrison was out of network.

Regence customers who have questions about receiving care at Harrison should call the customer service number on their insurance cards.

Customers who want to file a complaint can contact the state Insurance Commissioner at (800) 562-6900. Complaints can also be filed at www.insurance.wa.gov.

These are the seven zip codes excluded from the emergency care agreement: 98322 (Burley); 98353 (Manchester); 98359 (Olalla); 98366 (Port Orchard); 98367 (Port Orchard); 98384 (South Colby); and 98386 (Southworth).

Customers in those zip codes can still access emergency care at Harrison and be covered by Regence at an in-network level. But Harrison could send them an additional bill to cover the full cost of their care, a practice called “balance billing.” Those SK customers received this letter from Regence.

Two more notes on the Regence/Harrison situation:

  • Harrison does have discounts available for Regence customers who want to access primary or specialty care. More information is available by calling 1-888-779-6380. UPDATE: These discounts will only continue through February unless they’re extended.
  • Everyone involved agrees a new contract between Regence and Harrison is the best longterm scenario. Still, there’s no progress to report on that front. It’s unclear when serious talks might resume.

Finally, here’s that letter Regence sent to most of its Kitsap customers regarding the emergency care agreement:

Member Letter WA 1.5.14

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