Covered CA, Blue Shield of CA, & Beaver Medical Group

[MIM]

So I guess word just came out that Beaver Medical Group will no longer be accepting Covered CA plans through Blue Shield of CA.

Since the networks can't be different between on and off exchange, will Beaver be disciplined for terminating the agreement ?

So they will probably have to choose between being able to take Blue Shield of California all together or not at all.

I spoke with Blue Shield of Ca and as far as they're concerned, Beaver is still listed as being in network. From what I'm hearing, Beaver has not notified Blue Shield that they have terminated the agreement and Beaver has not yet notified any of their patients. In the meantime, Blue Shield is telling me to tell my clients that they should call customer service. (What is that going to do for them ?)

I don't have time to wait for the dust to settle on this. I'm going to be the one with egg on my face on this one. So I guess my only recourse is to look for an SEP and start moving my clients ?

What has everyone else's experience been on something similar to this ?

Thanks guys!

MIM

 

[Yagents]

You are over reacting. Either you can't move them without SEP or the contract will b signed minutes be for deadline, or find a new doctor. It's out of your control and aca limits your choices to change mid year

 

[MIM]

You are over reacting. Either you can't move them without SEP or the contract will b signed minutes be for deadline, or find a new doctor. It's out of your control and aca limits your choices to change mid year

No, I don't think I'm overreacting. I really care about my clients so if that's considered overreacting then I don't know what to say. I guess I should have given more details to my post. Beaver Medical Group is really the only medical group that is in network at all for Blue Shield of California for Covered California. So that relationship going down the toilet has left subscribers no other viable option in the area where I am at. Since there is no other provider, either subscribers will simply stop paying their premiums or they will move via an SEP if Beaver chooses not to take back those subscribers. I've already called Covered California and they have told me that if they wish to move, they will make an exception and create an SEP for them. Considering ACA needs as many active subscribers as possible, I seriously doubt they're going to give much resistance in letting them move.

My clients could just wait it out while they sort things out amongst themselves, but I really don't expect them to do this while waiting on needed services that they were promised. In the future, I think I will steer clear of Big Blue to save myself the heart ache. Thank you for your input!


MIM

 

[kgmom219]

YAgents is right.

Beaver Med can't lose Blue Shield.

Blue Shield can't lose Beaver Med

This is a ploy during contract negotiations.

Plus or minus 2 weeks from termination date an agreement will be finalized and all will be well.

If you have something in writing, sending out an email to your clients isn't a horrible idea, if you list the other providers in the area. Add that you are confident they will work it out. And that there is nothing they can do until OEP.