A major health insurance company and the only major hospital in Yavapai County have not come to an agreement over contract terms that has left more than 11,000 members out of network care for many services.
Blue Cross Blue Shield of Arizona and Yavapai Regional Medical Center could not come to a contract agreement earlier this month, and they have not come to the table since.
However, State Senator Ken Bennet, who represents the Prescott area said that both companies appear to want to meet again, “I’m told by one of them, both of them, in one way or another that they’re not too far apart,” he said.
In a statement to ABC15, Yavapai Regional Medical Center stated it hopes to re-engage promptly:
Blue Cross Blue Shield of Arizona (BCBSAZ) has not re-engaged in negotiations since rejecting our proposal on Feb. 8. We have made it clear to BCBSAZ that we would welcome them back to the table to either accept our proposal or provide a counter proposal that is fair and will allow us to continue providing the essential services the residents of Yavapai County deserve. We believe both parties have a responsibility to the community to reach an agreement and we have always been open to further discussions. We hope BCBSAZ will promptly re-engage in negotiations and agree to an equitable contract that will put patients first and allow us to continue providing our full range of health care services.
As for BCBS AZ, a spokesperson wrote by email writing:
No further developments have been made. During negotiations, we had increased our offer to meet Yavapai Regional Medical Center in the middle on rates and offered two contract options to move forward. Yavapai Regional Medical Center could change their decision to stay in the network and we’d welcome them to meet us at the table to discuss an agreement at any time.
ABC15 reported earlier this month that the move does not affect all their members and emergency care, even at Yavapai Regional Medical Center, and is still covered at in-network rates.
This does not apply to many members in Yavapai County, including those enrolled in:
- BCBSAZ Health Choice (AHCCCS or DSNP)
- Federal Employee Program (FEP) not impacted through the end of 2023
- HMO plans using the Neighborhood Network are not impacted through the end of 2023.
- Senior Security Medicare Supplement
After February 8, if your plan uses one of the following networks, Yavapai Regional Medical Center (YRMC) hospital facilities, and their hospital-based physician group it will be considered out of network:
- PPO or EPO plans using the Statewide/National PPO Network
- HMO plans using the Statewide HMO Network
- Medicare Supplement plans using the Senior Preferred Medicare Supplement Network
- Plans using the BCBSAZ Workers Compensation Network
BCBSAZ emphasized that an ER visit for members will still be in-network status.
For those who have Senior Security Medicare Supplement, some may be impacted.
Here's how to check your Member ID:
- If your member ID begins with “R”, “NNJ”, or “NNG”, “HC”, “MZH” this contract termination does not apply to you.
- If your member ID Card starts with “XBS” refer to the product name on your card.
- If your card says Medicare Supplement Senior Security plan this contract termination does not apply to you. If your card says Medicare Supplement Senior Preferred plan, this does apply to you.
- If your member ID begins with any other letter combination, this contract termination may apply to you.
ABC15 reached out to both of Arizona's U.S. senators, and they released the following statements.
Senator Kyrsten Sinema:
“I remain concerned for Arizonans who are unable to receive hospital care close to home or with their preferred care teams, without risking high out-of-pocket costs for being out-of-network. I’m calling on the leadership of Blue Cross Blue Shield Arizona and Yavapai Regional Medical Center to continue negotiations so we can keep access to care for impacted Arizonans and patients.”
Senator Mark Kelly:
“Senator Kelly has urged both sides to come to an agreement and is disappointed that they haven’t. He’s concerned about the gap that this leaves with many Arizonans unable to use their health insurance at the hospital most convenient to them, instead potentially having to travel long distances for care. He continues to encourage the two sides to find common ground so Arizona patients can get the care they need in the community.”
