FMC Fresenius - what next --

[dialysisadvocate]

(from www.renalweb.com)

 Blue Cross Blue Shield of NC: Fresenius Medical Care Dialysis Centers Terminates BCBSNC Contract

Friday, July 6, 2012


 

BCBSNC: Fresenius Medical Care Dialysis Centers Terminates BCBSNC Contract



On June 26, 2012, Blue Cross Blue Shield of North Carolina (BCBSNC) announced that Fresenius Medical Care (FMC), one of the network dialysis providers, notified BCBSNC of its intent to terminate their commercial contract with BCBSNC effective July 30, 2012. Fresenius also sent a termination notice for their Medicare Advantage contract effective August 18, 2012. These notices were sent after BCBSNC refused their request to be paid many times the standard Medicare rates for dialysis care.
 
BCBSNC asked that Fresenius rescind their termination notice and resume contract negotiations. BCBSNC has not yet received a response from Fresenius. As of June, there are 258 members who have received dialysis care recently from an FMC facility.
 



Members who choose not to transition from Fresenius to another participating dialysis provider will be impacted by higher out-of-network costs, including applicable out-of-network deductibles and higher coinsurance.  Members with access issues as a result of Fresenius’ termination can continue receiving care at a Fresenius site, which BCBSNC continue to pay at the in-network benefit level.
 



Communication Plan Overview
 
Fresenius was removed from the commercial online provider directory in early June.


On June 11, a letter from Dr. Garrett, BCBSNC medical director, was sent to all BCBSNC in-network nephrologists, informing them of the situation and encouraging the doctors to refer their patients to an in-network dialysis center.


On June 26 BCBSNC mailed the letter attached to members who have received dialysis care recently from a Fresenius facility, along with the standard continuity of care letter. 


The letter included a phone number for a dedicated line to handle these calls. Staff handling these calls will assist members in finding and transitioning to an in-network dialysis center, if appropriate.


BCBSNC will also be following the letter with personal calls to ensure the member’s understanding and to assist with the transition of care as needed.
 



Posted by Senn Dunn Insurance at 11:18 AM

Labels: BCBSNC, dialysis, Fresenius Medical Care, termination