Tag Archives: regence blueshield

First Choice Health could drop Harrison hospital

Harrison Medical Center will fall out of network with insurer First Choice Health if the two sides can’t agree on a new contract by Sept. 1.

Bob Hinman, First Choice vice president for network management, said contract negotiations with Harrison have reached an impasse.

First Choice believes reimbursement rates Harrison receives under the current contract are unfairly high, Hinman said. He was hopeful talks would continue.

“I think that’s everyone’s hope we could come to agreement on appropriate terms,” he said.

Hinman said First Choice has roughly 3,000 customers in Harrison’s market, and has included the hospital in its network since the 1990s.

The insurer sent a notice to clients warning them the contract with Harrison may terminate in September. If Harrison is dropped from the provider network, First Choice customers will have to pay much higher out-of-pocket costs to access services at the hospital.

The contract in jeopardy only covers Harrison Medical Center. Harrison HealthPartners physicians have a separate contract with First Choice, Hinman said.

Representatives of CHI Franciscan Health, Harrison’s parent company, remained confident an agreement would be reached.

“We are in active contract discussions with First Choice Health and anticipate to have a resolution before the September 1 deadline,” CHI Franciscan spokesman Shawn Jennison said in a statement.

Harrison has had rocky relations with insurance carriers over the past few years. A contract between the hospital and UnitedHealthcare terminated in December 2013. Harrison rejoined United’s network in April 2015.

Harrison and Regence BlueShield failed to renew a contract in August 2014, prompting widespread outcry among Kitsap customers. Regence and Harrison signed a new agreement in February 2015.

First Choice Health is a Seattle-based health care company owned by physicians and hospitals.

If you have insurance through First Choice I would love to hear from you. Drop me an email at tad.sooter@kitsapsun.com or leave a comment below.

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Harrison/Regence split inspires legislation

Tad Sooter

The messy split between Harrison Medical Center and Regence BlueShield last year was the inspiration for a bill introduced Wednesday in the state Senate.

Senate Bill 5648, sponsored by Sen. Christine Rolfes, D-Bainbridge Island, would add a section to the state Patient Bill of Rights to “ensure continuity of health insurance coverage in the event of a split between hospitals and insurers,” according to a news release.

The bill would add a section to the Bill of Rights guaranteeing patients in-network access to their hospital through the end of their plan year, even if their insurance carrier drops its contract with the hospital.

For example, if an insurance company terminated its contract with a hospital in August, those customers could still access the hospital at an in-network level through the end of December, and couldn’t be balance billed for the full cost of their care.

The bill is supported by the state Office of the Insurance Commissioner.

“When you buy a health plan, you expect to have access to vital providers when you need them,” Insurance Commissioner Mike Kreidler said in the release. “You also expect to pay the costs your policy outlines. This legislation would protect consumers from potentially huge financial bills that could arise during a contract breakdown.”

Rolfes began researching the issue after hearing complaints from Kitsap constituents following the termination of Regence’s contract with Harrison.

Rolfes and the Office of the Insurance Commissioner prodded the two sides into reaching a deal that would prevent Harrison from balance billing Regence customers for emergency care.

The agreement was retroactive back to the August termination date. (Harrison representatives said the hospital hadn’t been balance billing Regence customers anyway).

You can read my most recent post about the Harrison/Regence situation here. Continue reading →

More information about Regence and Harrison

Tad Sooter

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 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. Continue reading →

Harrison’s letter to Regence customers

Tad Sooter

There was a lot of anger in the wake of the Thursday announcement that a contract between Harrison Medical Center and Regence BlueShield would terminate, and much of it was directed toward the local hospital.

Harrison sent a notice Friday to its patients covered by Regence with a letter from interim Harrison President Joe Kortum. (Longtime CEO Scott Bosch retired last month).

In the letter, Kortum expressed disappointment in the outcome of the negotiations and apologized to patients for the disruption. The letter also lists insurance still accepted by Harrison, with a suggestion that Regence customers to talk to their employers about switching carriers during the next enrollment period.

Here’s the full letter to patients:

Regence, Harrison pact good through Aug. 21

Tad Sooter

As we reported earlier, Regence BlueShield and Harrison Medical Center temporarily extended their existing contract while the two sides continue to hammer out a new agreement.

A spokesman for Franciscan Health System, which is negotiating on behalf of Harrison, confirmed the temporary pact will be in place through Aug. 21:

Franciscan Health System and Regence BlueShield of Washington have agreed to extend their negotiations on a new contract for Harrison Medical Center and Harrison HealthPartners through August 21, 2014.

We understand that this is a difficult and confusing time for Harrison patients who are Regence of BlueShield of Washington members. We are working diligently to try to reach a new agreement with Regence.

In a recent interview, Harrison board Chair Jim Civilla said the hospital recognizes patients are “caught in the middle” of the negotiations.

“We and the insurance companies have got to figure this out,” he said.