Springfield (Ill.) Clinic accused Blue Cross Blue Shield of Illinois of terminating its in-network provider agreement without warning, according to an ABC affiliate News Channel 20.
Six details:
1. The physician group told the news outlet June 11 that it has been unable to reach a new contract agreement with BCBSIL and its ASC will be out of network for members Aug. 19. The entire clinic will be out of network for BCBSIL members Nov. 17.
2. BCBSIL posted a statement on its website blaming Springfield Clinic for the split. The insurer said Springfield Clinic sent an improper 30-day termination notice for Blue Choice and accused Springfield Clinic of "misleading communication" to members.
3. Springfield Clinic told Herald & Review it notified 10,000 Blue Cross Blue Choice member patients in May that their status would become out of network July 1. The plan covers Illinois state employees and a few other local employer groups.
4. BCBSIL terminated all Blue Cross network agreements with Springfield Clinic when negotiations broke down over the Blue Choice contract, according to Herald & Review. Salma Khaleq, vice president of provider strategy and partnerships at BCBSIL, told the newspaper the insurer hoped the move would lead to "broader discussion" of value-based care contracts.
5. The contract termination will leave about 100,000 of Springfield Clinic's patients out of network.
6. Both parties are working to resolve the issue before their current contract ends.