If you use Texas Health Resources (THR) physicians, hospitals, and/or ancillary facilities for your health care, you have probably heard that THR and Blue Cross and Blue Shield of Texas (BCBSTX) are in contract negotiations and have not yet reached an agreement on terms.
The SMU Department of Human Resources has been closely monitoring the progress of the BCBSTX/THR negotiations and we are very hopeful that an agreement will be reached prior to the December 31, 2010, deadline.
Although SMU and other employers are aggressively encouraging BCBSTX and THR to reach an agreement by December 31, the final outcome rests with them. If an agreement is not reached, THR doctors, hospitals, and ancillary facilities will no longer participate in the BCBSTX BlueChoice PPO networks available to SMU employees, effective January 1, 2011.
– In the event that an agreement is not reached, BCBSTX has committed to providing detailed information regarding Transitional Care Benefits, which allows coverage at the in-network level of benefits (for a limited period of time) for members who are hospitalized as of December 31, past their 24th week of pregnancy, or are in an active course of treatment for certain acute medical conditions.
Additional Information
Please visit www.membersforafairdeal.com for additional information. You will find links to:
– A list of facilities and physicians that will be impacted if an agreement on contract terms is not reached
– A list of alternative in-network facilities
If you have additional questions, please call BCBSTX Customer Service at 877-768-2005. If you are asked, the SMU Group Number is 090138.
We expect to receive more detailed information very soon and will provide an update as soon as possible.
