Blue Cross Blue Shield insurance dispute may harm patients

About 100,000 Springfield Clinic patients in central Illinois would face higher out-of-pocket costs if they continued to use clinic doctors in August and beyond unless the clinic and the state’s largest insurance company can resolve a contractual dispute.

The private, multispecialty clinic notified patients insured by Blue Cross and Blue Shield commercial plans this week that the clinic is scheduled to change from an “in-network” to an “out-of-network” provider on Aug. 19 for the clinic’s Ambulatory Surgery and Endoscopy Center in Springfield, and on Nov. 17 for all clinic locations.

Clinic officials said they also sent letters in May to about 10,000 patients in a plan called Blue Cross Blue Choice about a potential July 1 change to out-of-network status. Springfield Clinic and Blue Cross officials disagree on whether network status for this group of patients would, in fact, change July 1.

There’s no disagreement, however, on the potential August and November dates for when the clinic would change to out-of-network status for the larger group of patients.

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Springfield Clinic's main campus in downtown Springfield.

Officials at Chicago-based Blue Cross and Blue Shield of Illinois and at Springfield Clinic said Friday they are attempting to resolve the dispute before what could become a major disruption in care in the region occurs.

Without a resolution, many Springfield Clinic patients would have to choose between paying drastically higher co-pays, deductibles and other costs for using an out-of-network provider or potentially switching to new doctors for in-network coverage, if that option is available.

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