Regence Blue Shield of Idaho Update
November 25, 2019
Regence Blue Shield of Idaho Update
St. Joseph Regional Medical Center will always provide patients with local access to the care they need, when they need it. We are here to serve our valued patients.
We know patients are hearing conflicting messages about our work with Regence Blue Shield of Idaho. We are working with Regence in good faith and with the goal of having a new contract in place before we go out-of-network on January 15, 2020. Our work with Regence is intended to ensure we are able to continue investing in patient care and our team members for the long-term. When we invest in patients, we are investing in the community. St. Joe’s employs nearly 1,000 team members and helps fuel our local economy by paying over $2.5 million in taxes each year.
Importantly, St. Joe’s works with insurance companies every day to ensure our valued patients have access to the care they need. It’s always our goal to have long-term insurance contracts in place to provide security for our patients. In fact, we recently worked with Blue Cross of Idaho and First Choice Health Networks on new, multi-year agreements that will ensure patients have the care they need, when they need it.
Like our patients, we are seeking clarity from Regence about how they will ensure patients’ continued access to the physicians and nurses our community knows and trusts.
What this means for Medicare Advantage patients:
- We understand patients have questions about how Regence will process Medicare Advantage claims. There have been conflicting messages, and we want to help protect patients from out-of-network charges. The fact is, St. Joe’s and our employed physicians will go out-of-network with Regence Blue Shield of Idaho on January 15, 2020.
- Medicare Advantage patients can use the Medicare Open Enrollment Period to understand their options. Medicare Open Enrollment ends on December 7, 2019.
- Regence Medicare Advantage patients should call the free Medicare Insurance Helpline before December 7, 2019 at 855.643.8137 to get the facts and understand their options.
- The Helpline provides patients with personalized assistance and will help patients select and enroll in a health plan with in-network access to St. Joe’s and our physicians.
What this means for commercially-insured patients:
Many health insurance plans have “continuity of care” benefits for patients in active medical treatment, such as patients receiving care in a hospital, cancer patients, or expecting mothers. The hospital does accept continuity of care benefits. Patients should call Regence to determine if they qualify for “continuity of care” benefits. Additionally, some patients will still have access to St. Joe’s through their out-of-network benefit. Here’s what you can do:
- Call Regence at the phone number listed on the back of your insurance card.
- Ask about your continuity of care benefits and out-of-network benefits.
- Encourage Regence to work with St. Joe’s to protect your access to care.
How did St. Joe’s and Regence Blue Shield of Idaho get in this situation?
Today, Regence Blue Shield of Idaho pays St. Joe’s at rates that are below market average for hospital and physician services. If this were to continue, we may be forced to consider re-investing less in future projects for our community because we have fewer resources and reducing access to some services our community deserves.
If I switch to another insurance provider, will I be covered?
St. Joe’s has relationships with a number of other insurance providers. We encourage you to call the Billing & Financial Services team at (208) 799-5533 to learn more about the “in-network” options that work best for you and your loved ones.
Are you negotiating with insurance providers other than Regence Blue Shield of Idaho?
Our contract negotiations are only with Regence Blue Shield of Idaho. We will remain in-network with Blue Cross of Idaho, Premera Blue Cross of Washington, and other Blue Cross Blue Shield health insurance plans.
If I am / a patient is in active treatment at St. Joe’s prior to January 15, will I / they be considered out-of-network and have to pay the higher rates?
Patients who are in active treatment should call the number on the back of their insurance ID card and follow Regence Blue Shield’s procedure regarding “continuity of care.” Pregnant women and individuals undergoing treatment for specific diseases (e.g. cancer) will likely qualify for “continuity of care.” The hospital does accept continuity of care benefits.
Will patients coming through the Emergency Department after January 15th - emergencies that require an emergency procedure, etc. – be considered “out-of-network” or will Regence Blue Shield of Idaho be required to cover them?
All insurance companies are required to process emergency claims as an “in-network” benefit, so rest assured that you can always receive emergency care at St. Joe’s Emergency Department.
Is it just about money?
Fair agreements with insurance companies give St. Joe’s and our physicians the ability to continue reinvesting in the services we provide patients. Our goal in working with Regence Blue Shield of Idaho is to secure a fair rate for our services that allows continued reinvestment in patient care, enhanced services and facilities, recruitment of new physicians and caregivers and planning for our community’s healthcare future.
Our parent company’s status as a tax-paying entity has had a positive impact of $2,523,556 in additional taxes paid to support this community last year alone. Between these funds to help support public services and local construction projects, as well as the nearly $6 million we provide in charity care each year, we’re proud to continually reinvest in the future of our friends, families and neighbors.
About St. Joseph Regional Medical Center
St. Joseph Regional Medical Center, part of LifePoint Health, is the largest full-service regional Medical Center between Boise and Spokane providing advanced-level specialty healthcare. Our commitment to providing safe, exceptional care for our community means having highly skilled and certified physicians on our healthcare team and a quality facility with the latest in medical technology. St. Joseph has more than 120 board-certified physicians and providers, active in both primary care and specialty practice. We seek to enhance the quality of life of the citizens we serve in our local communities through the promotion of health, by assuring compassion, sharing knowledge, providing technology, and communicating a love for what we do. St. Joseph Regional Medical Center – Making Communities Healthier®.