Are the doctors in the Willis-Knighton Physician Network leaving my network?
The Willis-Knighton Health System recently let us know that it plans to remove its doctors from all Blue Cross and Blue Shield of Louisiana provider networks.
According to the health system, May 15, 2014, will be the last day its doctors will participate in Blue Cross or HMO Louisiana, Inc., provider networks. Please note: This action affects only the doctors who work in the Willis-Knighton Health System, not the Willis-Knighton hospitals.
Before you schedule an appointment with a doctor, we suggest that you use our searchable online provider directory or call us at the number on your member ID card to see if the doctor is still in our networks. We will send you a letter if a doctor you’ve seen in the past 18 months leaves our networks.
When will this happen:
For Blue Cross and HMO Louisiana Members ONLY:
For Blue Cross and HMO Louisiana members, these providers will be out of network beginning May 16. If an agreement is not reached, Blue Cross and HMO Louisiana members will be mailed a letter explaining what they can expect if they see a Willis-Knighton Physician Network doctor out of network. See below for more frequently asked questions.
For Federal Employee Program Members ONLY:
Because the Willis-Knighton Physician Network has told us it will end its network participation, the Federal Employee Program requires us to notify Program members as early as possible. The letter must explain that we will continue to provide benefits for covered services from these doctors at the Preferred level for 90 days from the mail date of the letter. Federal Employee Program members have been mailed this letter, which also explains the differences in how each Federal Employee Program plan is affected by this change.
How to find a new doctor:
As a Blue Cross or HMO Louisiana member, you have access to a broad network of doctors and other providers to serve your healthcare needs. To receive the highest level of benefits, you should seek care from a doctor who is in your network. Click to Find a Doctor. You can also do the following:
What if my doctor has another office?
Some doctors, who are part of the Willis-Knighton Physician Network, have other office locations that are not part of the Willis-Knighton system. This means those doctors may still be in network when they see patients at those other locations only. If the doctor has more than one location, and you prefer to continue seeing that doctor instead of seeking care from another, be sure to visit your doctor at the location that’s in the network. There are several ways to check this information:
What about the doctors who work at Willis-Knighton hospitals?
Willis-Knighton Hospitals are still in your network, although you should check to see if some hospital-based doctors are in your network. Hospital-based providers are anesthesiologists, emergency room doctors, neonatologists, pathologists and radiologists. If they are not in network, these doctors can bill you for the difference between what they charge and what your plan allows for their services. You can check to see if these doctors are in network at www.bcbsla.com/hbp.
Why are the doctors leaving the network?
The doctors have told us they will leave the networks because Blue Cross cannot agree to their demand for higher payments and special terms that we find unreasonable and outside of a typical provider agreement.
Why can’t Blue Cross agree to Willis-Knighton Physician Networks’ terms?
Agreeing to Willis-Knighton Physician Network’s new terms would upset the balance of healthcare costs in the Shreveport area, making costs higher for everyone.
The Shreveport area is one of the highest cost areas in the state for private insurance coverage. The prices we already pay Willis-Knighton doctors are very competitive compared to what we would pay other doctors in your network for the care they give our members.
Blue Cross is a not-for-profit company owned by our members. Our members have insisted that we do something about the high price of healthcare. In fact, we’ve long been a leader in the fight to bring healthcare costs under control. One of the many ways we do this is by negotiating with healthcare providers to ensure that we are paying appropriate prices on behalf of our members.
We have to be good stewards of your premium dollars. We cannot agree to unjustified demands from healthcare providers. We must all do our part if we’re going to tackle the high cost of healthcare.
Is there a chance both companies will agree?
We have had a long-standing relationship with the Willis-Knighton Physician Network. Our door is always open should the Willis-Knighton doctors wish to continue taking part in your network. We would welcome the chance to work with them on an agreement that is in the best interests of the customers we share.
How will this change affect my coverage?
It’s important to remember that beginning May 16, 2014, Willis-Knighton Physician Network doctors will be out of our networks. If you go to a Willis-Knighton doctor on or after that date, you can expect the following:
What if I have a previously authorized service beyond May 15, 2014?
Beginning May 1, Blue Cross Care Management nurses will contact each member who has an authorized service beyond May 15, 2014, to help them find another provider in the network for their authorized service. If you have questions about authorizations, you should call the Customer Service number on your ID card and ask to speak with a Blue Cross and Blue Shield of Louisiana nurse.
I am receiving care for a serious illness. Can I continue treatment with my doctor?
Some members may qualify for in-network benefits by a Willis-Knighton doctor under our Continuity of Care provisions. Continuity of Care waivers, issued under special circumstances, allow you to continue care with non-network providers at the higher in-network level of benefits for a limited time.
You may be eligible if you are receiving care for certain conditions, such as a pregnancy past the 24th week or a high-risk pregnancy, or for a life-threatening illness for which you are undergoing a course of treatment, such as a diagnosis of cancer. If you think you qualify, please speak to your Willis-Knighton doctor about providing Blue Cross with a Continuity of Care waiver [PDF].
How can I stay updated on this situation?
Please refresh this page for updates, answers to frequently asked questions and other information to help you stay informed. If you are interested in speaking with a Blue Cross and Blue Shield of Louisiana representative to help answer your additional questions, please contact Customer Service at the number on your Blue Cross ID card.
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