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MEDICARE SECTION
Will EXCELLUS BCBS and FAMILY CARE MEDICAL GROUP Come To A Contract Agreement, By Year End?
In this months newsletter, I am writing about a contract negotiation between an insurance carrier and a medical provider.Â
A client gave me a “heads up” this morning about a potential coverage issue with Excellus BCBS insurance plans if an agreement isn’t worked out by year end.
Patients are now being caught in the middle of another contract dispute between Excellus BCBS and Family Care Medical Group. This is the second time that Family Care Medical Group is putting pressure on Excellus BCBS. “Patients say they received a letter from the practice recently, notifying them of their intent to drop Excellus BlueCross BlueShield if a mutual agreement is not reached by December 31, 2024.”
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There is a current coverage issue with WellNow Urgent Care not being
in-network. Now, a contractual agreement with Family Care Medical Group is “iffy” again.
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Here is a video news clip from ABC “Your Stories”:   VIDEO: https://search.app/3kkX34nVQkWbphL57
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TO MY CLIENTS:Â
If you need to go to Urgent Care (WellNow) in New York, Excellus BCBS Medicare Advantage plans are PPO plans, which means you have coverage in-network and out-of-network.Â
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The out-of-network copay for urgent care is the same as the in-network copay. If WellNow won’t submit the bill or bill to Excellus for you then you can submit the paid bill to Excellus to request reimbursement.Â
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We will have to wait and see what happens with Family Care Medical Group.
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The Annual Enrollment Period to make insurance changes is
October 15th to December 7th … annually.
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