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Cracking down on out-of-network patients

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Go away, out-of-networkers told.

Health systems are getting tough on out-of-insurance network patients.

The St. Louis Post Dispatch reports:

“With many consumers currently selecting insurance plans, the area’s biggest hospital system wants them to think twice before picking a plan that doesn’t include BJC as an in-network provider.”

“A BJC {BJC HealthCare} announced its plans in a room full of insurance brokers at an industry meeting at the end of September….”

“The message was very clear, ” Emily Bremer, a partner at Bremer Conley, a Clayton, Mo.-based insurance brokerage firm, told the Post-Dispatch:

“’From now on, if you choose an insurance plan that does not have BJC we will turn you away.”

BJC HealthCare disputed that characterization, the paper said. “The nonprofit system will first redirect patients to an in-network provider. If out-of-network patients still want to seek care with BJC, they can; they’ll just need to provide a ‘secure form’ of payment upfront in nonemergency situations. That would include a credit card.”

“BJC says it’s ‘not appropriate’ for a consumer to knowingly choose a plan with lower premiums and then seek care at a hospital, or with a physician, that is out-of-network.”

“Plans using preferred provider organizations, or PPOs, may have a narrow choice of providers, but they allow consumers to go outside the network.”


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