Regence BlueShield of Idaho Update

 

We are here for you.

St. Joseph Regional Medical Center will always provide care to any patient who walks through our doors – regardless of the patient’s insurance status.

We have been trying to work with Regence BlueShield of Idaho for several months and we have offered Regence multiple solutions to protect your access to in-network care. Unfortunately, Regence is refusing to be a good local partner to St. Joseph and will no longer consider St. Joseph or our physicians and nurses as part of its network as of January 15, 2020.

In recent years Regence has consistently charged patients more and more for their monthly health insurance premiums, while reimbursing St. Joseph less each year for the care our team provides. This is unfair to patients and its unsustainable for St. Joseph.

As caregivers we take an oath to treat any individual in need of care and we will fulfill that oath. Insurance companies, like Regence, have an obligation to pay for the care we provide The team at St. Joseph is doing our part - providing life saving care. It’s time for the Regence and its Portland-based parent company Cambia, to do their part to ensure Lewiston patients have in-network access to local care.

We believe no patient should be left out-of-network by their Regence BlueShield of Idaho health insurance coverage. We are here to help patients receive the quality, local care they deserve, and we want to help you understand your options.

Patient Action: 

St. Joseph is the region’s most comprehensive hospital and patients can continue to trust our team to provide life-saving care. We will work with patients to achieve pre-authorizations as needed.

St. Joseph will continue to treat all patients in need of emergency care through our hospital’s Emergency Room.

MEDICARE ADVANTAGE PATIENTS:

  • You can call MedicareCompareUSA at 855-643-8137. The Medicare Open Enrollment Period runs through March 30, 2020. Between now and March 30, MedicareCompareUSA can help patients select a new Medicare Advantage plan that is in-network with St. Joseph and our employed physicians.

 

COMMERCIALLY INSURED PATIENTS:

  • You may still have access to St. Joseph and our employed physicians through their “out-of-network” benefit. Patients should call the Regence phone number found on the back of their insurance card to learn more. 
  • Many patients in active treatment or with certain illnesses can continue receiving care with “in-network” benefits through their continuity of care benefit. Patients should call Regence to learn more about continuity of care benefits.
  • We sincerely apologize for this inconvenience. Please know that we are actively working toward a resolution and will continue to keep you updated as we move forward.
  • If patients have additional questions, please call our team at (208) 799-5533 (hospital) or (208) 750-7464 (clinics).

 

To be clear, St. Joseph has in-network agreements with nearly all major insurance companies – except Regence. Regence has been unwilling to work toward an agreement with St. Joseph that will protect patients. We will continue to do all we can to reach an agreement that protects healthcare in our community and allows for long-term reinvestment in our region.

We’re doing our job – it’s time that Regence does theirs by ensuring patients have in-network access to the caregivers they know and trust. Please know that we are actively working toward a resolution and remain committed to you and to Making Communities Healthier.

 

FAQs

How do I know if I am impacted by St. Joseph’s work with Regence? 

If your health insurance card says Regence (in Idaho, Washington, Oregon or Utah), Asuris Northwest, Uniformed Medical Plan (UMP), Bridgespan, LifeMap and/or ValueCare, we urge you to protect yourself and your family by calling Regence at the phone number listed on your insurance card to see how you are impacted by Regence refusing to partner with St. Joseph. 

If you are a non-Regence member, you are not impacted and will continue to have in-network benefits and access to St. Joseph.

How will this impact my bill? 

We will do everything we can to shield patients from higher costs. Every patient bill will be evaluated on a case-by-case basis.  Ultimately, it will be up to Regence to decide how they reimburse for care the St. Joseph's team provides to protect patients from higher costs.

We believe no patient should be left out-of-network by their Regence BlueShield of Idaho health insurance coverage.  As caregivers, we have an obligation and took an oath to treat any individual who comes through our doors needing care. It's our insurance partners, like Regence, who have the obligation to pay for the care we provide.

We're doing our job - it's time that Regence does theirs, too. 

If I switch to another insurance provider, will I be covered? 

St. Joseph 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. 

How did St. Joseph and Regence get in this situation?

In recent years, Regence has consistently charged patients more and more for their monthly premiums, while reimbursing St. Joseph less each year for the care our team provides. This is unfair to patients and unsustainable for St. Joseph. To be clear, St. Joseph has in-network agreements with nearly all major insurance companies - except Regence. Regence has been unwilling to work toward an agreement with St. Joseph that will protect our patients. We will continue to do all we can to reach an agreement that protects patients, our local healthcare and allows for long-term reinvestment in our region. .  

Are you negotiating with insurance providers other than Regence? 

Our contract negotiations are only with Regence. However, Regence is part of Cambia Health Solutions.  Cambia Health Solutions companies include: Regence (in Idaho, Washington, Oregon and Utah), Asuris Northwest, BridgeSpan, LifeMap and ValueCare.  It also impacts plans administered by Regence such as Uniform Medical Plan (UMP).

We will remain in-network with Blue Cross of Idaho, Premera Blue Cross in Washington state, and other Blue Cross and/or Blue Shield health insurance plans.  

If I am / a patient is in active treatment at St. Joseph 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’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 15 - emergencies that require an emergency procedure, etc. – be considered “out-of-network” or will Regence BlueShield 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. Joseph's Emergency Department.

Is it just about money? 

Fair agreements with insurance companies give St. Joseph and our physicians the ability to continue reinvesting in the services we provide patients. Our goal in working with Regence 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.

 

 

 

MedicareCompareUSA is an independent insurance agency not affiliated with the federal Medicare program. St. Joseph Regional Medical Center receives no financial benefit when patients utilize the services of MedicareCompareUSA. All services are provided at no cost and without obligation, and Medicare beneficiaries are free to contact each Medicare plan directly, work with any qualified insurance agent, or access Medicare plan information by calling 1 (800) MEDICARE or online at www.medicare.gov.