Metroplex no longer part of Blue Cross Blue Shield of Texas netw - KXXV-TV News Channel 25 - Central Texas News and Weather for Waco, Temple, Killeen |

KILLEEN

Metroplex no longer part of Blue Cross Blue Shield of Texas network

KILLEEN, TX (KXXV) - Starting April 7, Metroplex Hospital and Rollins Brook Community Hospital will no longer be part of the Blue Cross Blue Shield of Texas network.

Metroplex and the Adventist Health Systems ended their contract with BlueCross BlueShield Texas after the two could not come to an agreement about the rate at which the hospital was getting paid.

Metroplex CFO Robert Brock says they haven't had a rate increase since 2009. He says they cannot sustain business at those rates and they have lower rates compared to surrounding hospitals.

 "We're not asking to be paid more in fact we've said we'll take less but we need more than what we're being paid because we're consistently and significantly under paid," Brock said.

BlueCross BlueShield Chief Medical Officer Dr. Dan McCoy says the rate they have is appropriate for the area and they gave an increase in 2011.

 "Adventist proposed rate increases were really designed for larger profits for them straight from the pockets of our BCBS members," McCoy said.

Both McCoy and Brock do say the care for patients is their utmost priority. Those with the health insurance will still get emergency care and most plans offer non-emergency care as well. It just means there may be a higher deductible. However a small amount of plans are not accepted under the non-contract system with the hospital. To see what care you're still provided for with BlueCross BlueShield click here.

The two could not come to agreement before the contract deadline on Monday. Metroplex says they offered to accept less money if there was a third party audit to compare their rates to those of surrounding hospitals. BCBSTX says that would violate hospital contracts.

Negotiations are still ongoing but the two are having trouble coming to an agreement.

 "So we feel that our position is very justified under the circumstances and if we're to continue doing business in Central Texas here with blue cross then they need to come to the table with an acceptable rate," Brock said.
 
"Adventist requested a reimbursement rate that is more than ten times the current rate of inflation and would've added more than five million dollars annually. And that we think is unreasonable," McCoy said.
 
Those who have questions or need help, can call 817-551-2701 or visit www.mplex.org. Blue Cross Blue Shield members can go to www.bcbstx.com/adventist if they have questions of where they can get treatment.
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