Don’t Lose In-Network Access

 

Regence Blue Shield of Idaho insurance plans will no longer be “in-network” with St. Joseph Regional Medical Center or our physicians as of January 15, 2020.

 

We are working in good faith to ensure your continued access to the providers you know and trust. If we are unable to reach a new, fair agreement with Regence Blue Shield of Idaho, you will no longer have “in-network” access to St. Joseph or our physician group, which means you may see higher costs of care.

What this means for Regence Blue Shield of Idaho Patients

Medicare Patients 

  • St. Joseph and our physician group participate in a number of Medicare Advantage plans that provide “in-network” access to our services. Review your options during the Medicare annual enrollment period (October 15 through December 7). During the open enrollment period you can change plan or return to original Medicare and obtain a Medicare Supplement plan to cover deductibles and coinsurance. 

  • Call the Medicare Insurance Helpline, serviced by MedicareCompareUSA at 855-643-8137 (Mon-Fri: 6 a.m. to 5 p.m.) to review the Medicare plans accepted by St. Joseph Regional Medical Center. The helpline service is free and offers personalized assistance to help you compare and enroll in a Medicare Advantage or Supplement plan that is part St. Joseph network. 

Commercial Insurance Patients 

  • Reach out to Regence Blue Shield of Idaho regarding continuity of care for your plan. 

  • While you are speaking with your Regence Blue Shield of Idaho representative, urge them to negotiate a fair contract to remain “in-network” with St. Joseph Regional Medical Center and our employed physicians. 

  • If you have employer-sponsored coverage, talk to your employer about going with a different insurance plan for 2020. 

  • If you purchased your coverage through a broker, he or she may be able to assist you in identifying a plan that is “in-network” with St. Joseph Regional Medical Center and our employed physicians. 

 

Our Commitment to You

We consider it an honor and a privilege to care for our community and are aiming to ensure all patients have access to the care they need, when they need it and from the providers they rely on regularly. Ensuring that we can continue meeting the community’s healthcare needs is a top priority in our discussions with Regence Blue Shield of Idaho.

 

We sincerely apologize for any inconvenience you may experience. Please know that we are actively working toward a resolution and will continue to keep you updated as we move forward. 

 

 

Regence Blue Shield - Myth vs Fact FAQ

Q: I heard St. Joseph reached a new contract with Regence – is that true?

A: As of today, we have not reached a new contract with Regence Blue Shield of Idaho. We continue to negotiate in good faith, and it is our goal to reach a new agreement before our Regence contract ends on January 15, 2020.

Q: Are you negotiating with insurance providers other than Regence Blue Shield of Idaho?

A: Our contract negotiations are only with Regence Blue Shield of Idaho. We will remain in-network with Blue Cross of Idaho and other Blue Cross Blue Shield health insurance plans.

Q: How did St. Joseph and Regence Blue Shield of Idaho get in this situation?

A: Today, Regence Blue Shield of Idaho pays St. Joseph 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.

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

A: St. Joseph has relationships with a number of other insurance providers. I’d 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.

Q: If I am / a patient is an OB patient who will not deliver prior to January 15, will I / they be considered out-of-network and have to pay the higher rates? What about patients receiving cancer care treatments?

A: Patients who are currently pregnant and will not deliver prior to January 15 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.” Regence-insured patients can learn more about their “continuity of care” benefits by calling the phone number on the back of their insurance card.

Q: 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?

A: 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.

Q: Is it just about money?

A: Fair agreements with insurance companies gives St. Joseph 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.

 

 

 

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.