Thursday, September 15, 2022

Behind the Scenes at the Blue Cross-UMC War

 Correspondence at the Department of Insurance shows the Blue Cross- UMC battle raging behind the scenes while patients were screwed in the middle.  Y'all Politics obtained the emails and letters through a public records request and posted them.  Y'all Politics reported yesterday: 

A trove of emails and letters obtained via a public records request by Y’all Politics give a unique behind the scenes look as to some of the inner workings of what’s actually happening with Mississippi Insurance Commissioner Mike Chaney, his staff, and representatives from UMMC and Blue Cross in mediating the nearly 8 month fight over network insurance coverage at Mississippi’s largest medical facility.....

In the public records request provided from MS Insurance Department (MID), there is a combination of:

  • Correspondence between MID, UMMC and BCBS
  • Correspondence with state and federal elected officials and their staff regarding the impact on policyholders and those seeking care
  • Patient stories from all sides, many stemming from complaints directly to MID, about the conduct of both UMMC and BCBS. Many of those stories are presented by one side or the other to essentially weaponize the public narrative.

Chaney in his correspondence has alternatively pleaded with both sides collectively to negotiate in good faith and applied leverage to both sides to rectify behavior that is not in the best interest of policyholders and those seeking and essentially being denied care due to excessive financial requirements.

With the media spin somewhat out of control on this matter, it is unlikely that a full presentation of the facts behind the scenes would be otherwise provided by other local or national outlets.  

An example of one of the letters to Chaney is from the administrative head of a local ear nose and throat practice:...

Read the rest of the article and check out some of the correspondence.

 

11 comments:

For-profit health care said...

Move along, nothing to see here

Anonymous said...

Everyone is on their own. Your employer doesn’t care about you. Your insurance company doesn’t care about you. Your central banker doesn’t care about you. Your doctor doesn’t really care either. The people who are still working are burning out because they are doing more for less compensation.
This is why the world is quietly quitting. Hopefully reliable AI and robot workers will be available soon, because society and supply chains are slowly collapsing all around us.

Anonymous said...

Never use UMC. My wife broke her leg while hiking. We went to UMC's ER and after waiting 10 hours, they came to us and said sorry Rapid Track is closed for the night, and to come back tomorrow when they open and maybe they will see her but they don't know for sure.

We went to Merit Health Central behind the Hwy 18 walmart, and their fast track saw my wife in 5 minutes and after 30 minutes had her an appointent with one of their orthapedic surgeons for 2 hours later.

Note we have non-BCBS health insurance.

Anonymous said...

UMMC has always been a disaster. Incredible to me no one has done any investigative reporting into the constant turnover of Department Chairs there, the fact that the entire Vice Chancellor's office comes from one clinical area and does not have universal perspective.

Anonymous said...

Both are pretty shitty, but I still think BCBSMS is the shittier of the two shitters.

Anonymous said...

BCBS of MS has more money in reserves than 90% of the BCBS entities across the country.

They have struck better deals and have kept payments much lower while being able to increase premiums.

BCBS built a state of tre art facility at Baptist (I think) in Madison where it’s really all in one treatment - physical , labs, virtual call with needed specialists, PT , weight coaches and plans and facilities and meetings….sounds utopian….

Anonymous said...

UMMC is more concerned with money, optics, and political power - insurance companies generally get a really bad rap due to the onset of managed care during the 1990s. Managed care does have a legitimate place at the table however to rein in money-hungry hospitals and other healthcare providers who frequently over-test, over-medicate, over-treat only to increase revenues not to provide proper healthcare. BCBS is merely trying to save the poorest, most unhealthy state out of pocket money and is expecting better health outcomes from UMMC.

UMMC isn't used to being managed and thinks it can use its Mis'ippi connections to get its way as it's always done in the past. Time will tell this round.

Anonymous said...

This will be settled. Both sides are losing revenue and paying huge legal bills. A deal is inevitable.

Anonymous said...

They are both awful... I say this as a state employee who has BCBS and a former UMMC employee. UMMC deserves to be sued for the ad campaign/smear campaign against BCBS as it is not factual; only fantasy. They are both at fault for being greedy and NOT ONE of them actually cares about the patient. It is a sad situation, but I blame UMMC more because they are supposed to be a teaching hospital and available for the residents of the state of Mississippi (according to the BS they spew). They are all liars.

Anonymous said...

What I know, as a
patient caught in the middle, is that even after meeting my deductible and going to "approved" providers, I am paying huge out of pocket costs for both a minor surgery and annual TESTS that were fully covered.

On my colonoscopy, which is $1425 for example ( and should save BCBS money to prevent a far more expensive hospital stay and surgery in the future) BCBS paid $400.
My medications( all generic now) are costing more in co-pay.
Thanks for sharing the proof that BCBS is ripping us off. And, yes, I've had two friends who had to go to Birmingham for procedures that could have been done at UMMC.
The executives of BCBS should be in prison as far as I'm concerned.

Anonymous said...

Correct picture given above.

Almost everyone in the highest echelons of the UMMC leadership comes from the ER Dept.
It is an ER cartel that is running everything now. Headed by the VC, an ER physician with just one publication to her credit in 30 years as faculty!!

A committee to decide on physician salaries was recently constituted by the VC; and comprised one-third ER people, one-third department chairs which total not even 30 faculty members in all, and one-third administrators from the C-suite. Not even one representative from the largest departments: Medicine, Surgery, or Pediatrics. And they will decide on salaries for all the faculty. It is a sham indeed.


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