Mission, Park Ridge set up call centers to help Blue Cross patients

Social workers help patients trying to get full coverage with Mission doctors after contract terminated with Blue Cross Blue Shield. (Photo credit: WLOS staff)

In an effort to help patients get coverage during the health insurance contract stalemate, Mission Health has opened a call center for patients with urgent medical care needs looking to stay with Mission doctors.

The center is open 8 a.m.-8 p.m. Monday through Friday.

Mission CEO Ron Paulus had touted a “continuity of coverage” insurance policy he said would cover these patients' medical care and allow them to continue with Mission doctors despite the impasse with Blue Cross. But, nearly seven days past the contract’s end, it’s unclear if Paulus’ statement will prove accurate.

One family who’s son has a brain tumor learned the day of the contract’s expiration that the continuity of care program would only cover their son’s main oncologist and not his team of doctors or ongoing tests, such as MRIs.

A Blue Cross spokesman said the insurer is committed to helping patients who have serious medical conditions despite the contract’s end with Mission, which puts all Mission doctors out-of-network.

Back at Mission’s call center, the eight social workers answering calls are assisting patients who want to try and sign up for the continuity of care policy. Mission representatives have said the hospital and doctors are committed to caring for patients, but Tina Donkervoet, director of patient care for Mission, said complications have arisen for patients who are trying to continue care with their Mission doctors, particularly when it comes to Blue Cross reimbursements for parts of patients' care since the contract ended.

“For some populations, what we're finding is not all of the services, or all the providers, are initially being approved,” Donkervoet said.

At Park Ridge Health, a staff of three health care professionals is taking patient calls, guiding them to new doctors who are in-network for Blue Cross Blue Shield. Park Ridge staff reports an increase in calls from patients looking to leave Mission doctors since July. Staff said the number of calls has continued to increase.

“We answer a lot of questions about Park Ridge services,” said Anita Slagle, who said a key part of the referral process is her and her staff’s ability to know the backgrounds of the local in-network doctors they’re referring patients to.

She said the calls coming in are largely from patients who are ready to leave their Mission doctors because of the fact that they’re no longer in-network for Blue Cross.

"Those patients are really nervous about getting in,” said Slagle. “They are looking for a provider in the area, close to home, who can accept their insurance."

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