LMC Hopes to Continue Negotiations with BlueCross BlueShield

Lexington Medical Center was disappointed to learn that BlueCross BlueShield of South Carolina sent its members and employers communication on Thursday stating that beginning March 1, 2015 Lexington Medical Center facilities and all of its employed physicians will no longer be considered “in-network” for the BlueCross’ Preferred Blue (PPO) plan.

LMC Aerial
Contrary to statements from BlueCross BlueShield, Lexington Medical Center has been working to negotiate fair and reasonable terms with the insurance provider for months, offering proposals that are in line with previous agreements and that will allow the hospital to continue providing excellent health care to the people of our community.

“Lexington Medical Center hopes to continue negotiating with BlueCross BlueShield before the March 1 deadline,” said Mike Biediger, President & CEO of Lexington Medical Center. “We hope that we can reach a mutually beneficial agreement to care for the patients we serve.”

Lexington Medical Center was surprised that BlueCross BlueShield publicly informed its members that negotiations had ended while the hospital was still in active discussions with them about the contract. In fact, the hospital thought it was very close to reaching an agreement. The substance of BlueCross BlueShield’s letter to members and employers has unnecessarily concerned members of the community, creating undue alarm and confusion. Lexington Medical Center has had a good relationship with BlueCross BlueShield for decades, and the hospital is very hopeful that an agreement can be reached.

Lexington Medical Center’s mission is to provide quality health services that meet the needs of our community, and the hospital is committed to furthering discussions with BlueCross BlueShield to best meet the needs of the patients we serve.

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13 Responses to “LMC Hopes to Continue Negotiations with BlueCross BlueShield”

  1. Interesting we’re hearing the exact opposite from our employer and BCBS. So, somebody’s not telling the truth. Hmmmmm……….who is it? Not real happy of the inability to meet in the middle especially since I’ve been with IMA for a number of years!

    • Hi Robert, Thanks for your comments. Lexington Medical Center is hoping to continue negotiations with BlueCross BlueShield to allow our patients who use the insurance provider to stay in-network with our doctors.

  2. I would think that LMC would agree that they are a community hospital–not a trauma center. LMC is situated with two other neighboring, competitive centers. Wanting to raise your contracted rates seems to shift the burden to the public, after all, insurance is a risk business. LMC is taking no risk–does not participate in the exchange plans and has “partnered” with Duke. Duke is a private institution that can pick and choose…does not offer community resources to families and does not accept out of state Medicaid to families who utilize them for transplant or other areas that are not offered in this state. LMC is not elite, although it is a nice facility. BCBS is being responsible and transparent by notifying members. BCBS has a responsibility to the entire community in aligning contract rates for all the local hospitals, the geographic region, and nationally. LMC has a responsibility to service its community as well. I would think that you would post signs in your facility and start assisting patients by making them aware of the balance billing and new out of pockets expenses. The Customer should always be first. BCBS did the right thing by sending me the letter. You would have just sent me a bill.

    • Thanks for your comments, Kathy. Lexington Medical Center is committed to its patients and looking forward to going back to the negotiating table with BlueCross BlueShield to reach an agreement that is beneficial to the patients we serve.

  3. why did you all not go with the 30 day extension until it is resolved bcbs had no choice but to give their clients a notice if they did not know what you was going to do. do not be so greedy i do not think lmc is loosing money . look at all the urgent cares you all own. LMC is the best thing that has happened to LEXINGTON AND NEIGHBORING COUNTIES. GOD WILL BLESS THE ONES THAT DOES GOOD WORKS AND SURELY NOT THE GEED.HE WILL LOOK OF LMC IF LMC LOOKS OUT FOR THEIR CUSTOMERS.

    • Hi Terry,
      BlueCross BlueShield offered us a 30 day extension to move our patients away from us to other providers. It was not an extension to continue negotiations. That’s why we said “No.” Lexington Medical Center wants to continue negotiations, and we’re hoping that BlueCross BlueShield will return to the table with us. We’re committed to working out this situation for our patients.

  4. From LMC:

    “BlueCross BlueShield offered us a 30 day extension to move our patients away from us to other providers. It was not an extension to continue negotiations.”

    Here is the absurdity of that statement. As long as LMC accepted the extension, there was no need for PPO members to look elsewhere. However, with LMC’s decision not to accept the extension, BCBSSC decided to drop LMC from it’s “in network” providers, forcing PPO members into insurance uncertainty. People will have to postpone or cancel surgical procedures as they no longer know what they will be responsible for.

    The “beauty” of insurance is the rate negotiated with the provider. People with no insurance pay MSRP, while all others pay less. What LMC has done is to force PPO members to pay MSRP if they decide to stay within it’s network.

    Try to spin that on the general population…

    • Thank you for your email, Ron. We’re happy to report that Lexington Medical Center has now reached an agreement with BlueCross BlueShield that will allow members who use Lexington Medical Center doctors and facilities to remain “in network.” We value you as a patient and understand our important role as a health care provider.

  5. I received a letter, dated 2/20/15 from BCBS today. Not happy about it. It clearly states “Effective March 1, 2015, Lexington Medical Center (LMC) facilities and all of its employed physicians will no longer be in BlueCross’ Preferred Blue (PPO) provider network.” Then on page 3, of the Q&A, it states “All LMC facilities” to include the hospital, urgent care, physician offices, diagnostic centers, along with making sure we find doctors with admitting privileges to an in-network facility. It’s crazy and a lot of work (emotional stress too) for families who will need to find other doctors, especially for us who have only used the LMC network. Please tell me LMC will work things out with BCBS so I do not have to do this!

    • Thankfully, Lexington Medical Center has reached an agreement with BlueCross BlueShield that will keep patients with doctors at our hospital in-network.

    • Thankfully, we’ve reached an agreement with BlueCross BlueShield that will allow Lexington Medical Center patients who use the insurance provider to remain “in network.”

  6. I saw on the BCBS website that they and LMC have reached an agreement. Is this true?

    • Yes! We’re happy to report that Lexington Medical Center patients who use BlueCross BlueShield will remain in-netowrk. There will be no disruption in coverage.

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