BREAKING: Mission Health now out of network with Blue Cross and Blue Shield of North Carolina

Contract expired at midnight Wednesday, Oct. 5

ASHEVILLE – Mission Health's contract with Blue Cross expired at midnight Wednesday, Oct. 5, and essentially all Mission Health physicians and facilities are now out-of-network providers with Blue Cross and Blue Shield of North Carolina, or BCBSNC, according to a press release from Mission Health.

Exceptions to Mission Health being out of network include:

• Emergency care, which always remains in network regardless of Mission's network status with BCBSNC;

• Blue Cross Federal employees who will remain in-network until Nov. 16;

• Care for patients with certain conditions who qualify for Continuity of Care;

• Care for patients whose care would otherwise be unduly delayed because of a lack of access to physicians or facilities without Mission Health;

• CarePartners physical therapy services, which go out of network March 3, 2018; and

• Services related to Blue Cross Medicare Supplement health plans.

BCBSNC members who purchased health insurance coverage on the Affordable Care Act exchanges will also be out of network.

"It is important that everyone is aware that you can keep your doctor and you can always choose Mission Health," said Dr. Ron Paulus, Mission Health CEO. "Although your health benefits may have changed, remember, emergency care is always in network, you can visit a doctor online at Mission-health.org/get-care.php regardless of your insurance for $25 from 7 a.m.-10:00 p.m. daily, you can communicate with your doctor through the patient portal at www.mission-health.org/connect-concierge.php for no fee and you can visit your doctor as an out-of-network provider taking into account our generous charity care and discount plans.”

Mission Health will not make any public comment about the contract situation under any circumstances until such time – if ever – it is fully resolved, Paulus said.

"The approach, content and pattern of communication from BCBSNC over the last four months have created a high likelihood of a circumstance where people could be misled by statements like ‘we're close,' even if we aren't even speaking," Paulus said. "Should a contract ever be reached between Mission and BCBSNC, we will announce it immediately. Until then, Mission's focus is exclusively on helping people who need care and people who are evaluating alternative health insurance options in the marketplace. Any BCBSNC employers or Medicare Advantage members in western North Carolina who want in-network access to Mission providers should immediately find other coverage."

Mission Health has left the door open for three offers of compromise to BCBSNC, according to the press release:

• BCBSNC could accept the offer Mission Health made in June;

• Mission Health could accept BCBSNC's demands for a "one year, zero-rate increase pause" as part of a long-term contract that also ensures Mission's long-term stability. This would be contingent upon BCBSNC having an "increase pause" for its customers; or

• BCBSNC and Mission Health could start anew and negotiate an agreement that ensures high-quality, affordable and effective care for the 1 million people who count on both organizations, according to the press release.

Emergency care and some specialty services will remain in-network as required by law. Mission will assist patients whose Mission providers are the only reasonable choice due to the patient's condition. Patients with questions should call the dedicated information line at 828-417-0480 or visit MissionStandsWithYou.org.

Patients with ongoing special conditions, including acute illness, chronic illness, pregnancy or a terminal illness insured by BCBSNC may continue receiving care from an out-of-network provider through Continuity of Care. Patients can learn more about who may qualify and how to apply by visiting MissionStandsWithYou.org.

AVAILABLE RESOURCES:

Using Mission Health Physicians.

• Physician visits available online at Mission-health.org/get-care.php.

• Mission Health patient portal at Mission-health.org/connect-concierge.php.

Questions about Continuity of Care.

• Call 828-412-6363 from 8 a.m.-8 p.m. Monday-Friday;

• In-person visits at the Mission Health Cancer Center, room 115, from 8 a.m.-5 p.m. Monday-Friday; or

• Apply for Continuity of Care at StandWithMission.org/Resources.

Call 828-417-0480 and a Mission Health representative will return the call and answer any questions.

The MItchell News

Mailing Address: PO Box 339 
Spruce Pine, NC 28777 
Phone: 828-765-7169
Fax: 828-765-1616