Nemours and Blue Cross Blue Shield

[SEANP]

I live in Orlando Florida and have Blue Cross Blue Shield PPO through my work. Our annual benefits enrolment period was several weeks back and I have had BCBS for the past few years with no problems, coverage wise, so I just let it roll over. Well of course 3 days after enrolment ended I get a letter from Nemours stating that they would no longer be a network provider with BCBS. I guess they are having charges and fee disputes and have not worked out a contract yet. Long story short has anyone else been faced with this? Has anyone heard if they have worked out a contract yet? I talked to our case manager at BCBS and because there are not any other CF certified clinic near they have to let my son use Nemours, but they will review every quarter to see if any new clinics will open up. I know that none will, but it makes me nervous that now I have someone checking out what is going on. It just stinks that 2 large companies like this can not agree and in the end it is the individuals that get affected and stressed out. If I had learned about this earlier, I could have switched to another insurance carrier. Just venting.......sorry.

 

[SEANP]

I live in Orlando Florida and have Blue Cross Blue Shield PPO through my work. Our annual benefits enrolment period was several weeks back and I have had BCBS for the past few years with no problems, coverage wise, so I just let it roll over. Well of course 3 days after enrolment ended I get a letter from Nemours stating that they would no longer be a network provider with BCBS. I guess they are having charges and fee disputes and have not worked out a contract yet. Long story short has anyone else been faced with this? Has anyone heard if they have worked out a contract yet? I talked to our case manager at BCBS and because there are not any other CF certified clinic near they have to let my son use Nemours, but they will review every quarter to see if any new clinics will open up. I know that none will, but it makes me nervous that now I have someone checking out what is going on. It just stinks that 2 large companies like this can not agree and in the end it is the individuals that get affected and stressed out. If I had learned about this earlier, I could have switched to another insurance carrier. Just venting.......sorry.

 

[SEANP]

I live in Orlando Florida and have Blue Cross Blue Shield PPO through my work. Our annual benefits enrolment period was several weeks back and I have had BCBS for the past few years with no problems, coverage wise, so I just let it roll over. Well of course 3 days after enrolment ended I get a letter from Nemours stating that they would no longer be a network provider with BCBS. I guess they are having charges and fee disputes and have not worked out a contract yet. Long story short has anyone else been faced with this? Has anyone heard if they have worked out a contract yet? I talked to our case manager at BCBS and because there are not any other CF certified clinic near they have to let my son use Nemours, but they will review every quarter to see if any new clinics will open up. I know that none will, but it makes me nervous that now I have someone checking out what is going on. It just stinks that 2 large companies like this can not agree and in the end it is the individuals that get affected and stressed out. If I had learned about this earlier, I could have switched to another insurance carrier. Just venting.......sorry.

 

[RiRi]

I know that BCBS of NC and Wake Forest Baptist University Medical Center in Winston Salem, NC were in a contract dispute at one point. They have since resolved it. It took a couple of months. Since Chapel Hill is a few hours away, BCBS members referred there for treatment if they wanted bills paid at the in network rate.

 

[RiRi]

I know that BCBS of NC and Wake Forest Baptist University Medical Center in Winston Salem, NC were in a contract dispute at one point. They have since resolved it. It took a couple of months. Since Chapel Hill is a few hours away, BCBS members referred there for treatment if they wanted bills paid at the in network rate.

 

[RiRi]

I know that BCBS of NC and Wake Forest Baptist University Medical Center in Winston Salem, NC were in a contract dispute at one point. They have since resolved it. It took a couple of months. Since Chapel Hill is a few hours away, BCBS members referred there for treatment if they wanted bills paid at the in network rate.

 

[Faith4Liliana]

I live in Saint Augustine, Fl and also have BCBS PPO and am having the same plm. I got a letter on Friday from Nemours saying that they haven't come to an agreement and as of Jan 1st my ins is an out of network ins. I am looking into CMS and Nemours Funding. We applyed for Medicaid after I got my first letter but got turned down. I am not sure what we are going to do. I can't afford to pay the out of network prices.

 

[Faith4Liliana]

I live in Saint Augustine, Fl and also have BCBS PPO and am having the same plm. I got a letter on Friday from Nemours saying that they haven't come to an agreement and as of Jan 1st my ins is an out of network ins. I am looking into CMS and Nemours Funding. We applyed for Medicaid after I got my first letter but got turned down. I am not sure what we are going to do. I can't afford to pay the out of network prices.

 

[Faith4Liliana]

I live in Saint Augustine, Fl and also have BCBS PPO and am having the same plm. I got a letter on Friday from Nemours saying that they haven't come to an agreement and as of Jan 1st my ins is an out of network ins. I am looking into CMS and Nemours Funding. We applyed for Medicaid after I got my first letter but got turned down. I am not sure what we are going to do. I can't afford to pay the out of network prices.

 

[SEANP]

Hi,

Definitely try to call BCBS and get a case worker assigned. I think there was a phone number on the letter that was sent out. Because there is no other "certified" center close by they allowed my son to continue seeing the Nemours center here in Orlando. I suppose each plan is different though. I just need to advise Nemours that they are allowing him to go out of network. I expect there to be some kind of mix up the first time he goes, but my case worker assigned some kind of special number for the billing. It is really sad that they can not work this out, especially right now at the holidays. From what I understand they have been trying to work this out for a couple of years now. In the end it is you and me that have to suffer and stress out over it.

Sean

 

[SEANP]

Hi,

Definitely try to call BCBS and get a case worker assigned. I think there was a phone number on the letter that was sent out. Because there is no other "certified" center close by they allowed my son to continue seeing the Nemours center here in Orlando. I suppose each plan is different though. I just need to advise Nemours that they are allowing him to go out of network. I expect there to be some kind of mix up the first time he goes, but my case worker assigned some kind of special number for the billing. It is really sad that they can not work this out, especially right now at the holidays. From what I understand they have been trying to work this out for a couple of years now. In the end it is you and me that have to suffer and stress out over it.

Sean

 

[SEANP]

Hi,

Definitely try to call BCBS and get a case worker assigned. I think there was a phone number on the letter that was sent out. Because there is no other "certified" center close by they allowed my son to continue seeing the Nemours center here in Orlando. I suppose each plan is different though. I just need to advise Nemours that they are allowing him to go out of network. I expect there to be some kind of mix up the first time he goes, but my case worker assigned some kind of special number for the billing. It is really sad that they can not work this out, especially right now at the holidays. From what I understand they have been trying to work this out for a couple of years now. In the end it is you and me that have to suffer and stress out over it.

Sean