Syracuse, New York — Carrie Case was told by FamilyCare Medical Group this month that negotiations with Excellus Blue Cross Blue Shield have gone virtually nowhere, and she could enter 2025 without her doctor’s insurance coverage. I am one of the thousands of people who received this letter.
“We don’t have anyone to help us, really. The news finally got through, sweetheart.” [can] Defending ourselves, our questions remain unanswered. You can sit on the phone for hours and not talk to anyone,” Case said.
She said she tried to do just that with representatives from Anthem Blue Cross Blue Shield, an independent sister company of Excellus, a Blue Cross Blue Shield company. After touring the area, Case finally gave up. She is currently trying to come up with a plan to pay for her doctor’s fees out-of-pocket in the new year when the Jan. 1 deadline hits and her current contract agreement with FamilyCare Medical Group expires.
“Now add insurance issues to that, everyone. [doctor’s offices] I’ll take anyone,” Case said.
An Excellus spokesperson said negotiations are underway with both FamilyCare Medical Group and Trinity Health, which covers St. Joseph’s Hospital in Syracuse and other facilities in central New York. Excellus says negotiations are moving in the right direction, but patients like Case are increasingly worried.
“Nobody’s going to work for us. We’re begging people,” Case said.
The problem in both cases is that providers say Excellus frequently denies patient claims and doesn’t provide enough reimbursement for needed care. Meanwhile, Excels said the interest rates were unreasonable.
On October 4, State Sen. John Mannion sent a letter to Excellus Blue Cross Blue Shield CEO Jim Reed expressing his concerns about this issue.
“Every precaution should be taken to ensure that no customer enters this year without health insurance or with insurance that is insufficient for their needs,” Sen. Mannion wrote in part. The health of our consumers is our top priority, and we sincerely hope that Excellus will meet with healthcare providers at the negotiating table and find mutually beneficial solutions to provide adequate and accessible coverage. Masu. ”
Taylor Waynes, a spokesperson for Congressman Brandon Williams, told CNY Central that Congressman Williams’ office is “engaged in ongoing discussions and would like to reassure all concerned that our community’s patients continue to be treated to the highest standards.” We urge them to find a solution as soon as possible so that they can receive medical care.” You can receive treatment from doctors you know and trust and insurance you can trust. ”
Onondaga County Councilman Kevin Meeker said lawmakers are aware of the issue but feel their hands are tied at the local level. He said if he were an Excellus customer, he would be looking for a new insurer now, with the commonality being that the nonprofit collects $6.6 billion in annual premiums.
