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How Much Will BCBS Of Tennessee Agree To Reimburse Memorial Health Care?

BCBS Of Tennessee Memorial Health Care System is an in-network hospital provider of Blue Cross Blue Shield of Tennessee. Every time a BCBS of Tennessee plan holder receives health care services from Memorial, the company pays a fraction of the cost to Memorial for the health care rendered. However, disputes arise with the terms presented by Memorial to Blue Cross Blue Shield of Tennessee for the renewal of the contract. Blue Cross Blue Shield of Tennessee’s contract with Memorial expired on July 31, 2012.

Memorial Health Care System wants BCBS of Tennessee to increase their reimbursement rate for the health care services that they are giving to BCBS of TN’s plan holders. According to Lisa McCluskey, the Vice President of Marketing Communications for Memorial, they just wanted a “fair” reimbursement rate from BCBS of Tennessee. That is why they proposed an increase. She said that they need the rate increase to be able to maintain and continue providing high-quality health care services.

So, will Blue Cross Blue Shield of Tennessee give in to the reimbursement rate increase set by Memorial? How much BCBS of TN is willing to reimburse Memorial for hospital care is still being discussed by the company’s leaders. One thing is sure, though. Blue Cross Blue Shield of Tennessee is not willing to pay the double-digit reimbursement rate increase that Memorial wants. That is why both companies are trying to negotiate to reach middle ground wherein both sides will get what they want and need.

The outcome of the contract would definitely affect a lot of people. Since BCBS of Tennessee holds approximately 45 percent of the market, Memorial could lose patients if the outcome is not in their favor. If Memorial is removed from BCBS of TN’s in-network providers, this would mean patients with plans from BCBS of TN will be charged out-of-network rates thus increasing their health care expenses. In this current economic situation, people are trying to avoid that situation.

Memorial Hospital officials said that they have a back-up plan in case they could not come to terms with BCBS of TN. This plan involves preventing BCBS of TN plan holders from paying out-of-network fees. McCluskey said that the hospital would make sure that these patients will be billed “appropriately.” This contract renewal would be a huge decision for both companies. Both parties should be prepared for the outcome of the final decision. Memorial with the potential loss of customers if their proposal is rejected, and BCBS of TN on how they’ll handle the plan holders getting health care from Memorial Hospital.

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