PMC, Blue Cross reach deal
After years of wranging, the hospital and the insurance provider forge an agreement with one another.
After years of those covered by Blue Cross Blue Shield of Georgia not being covered when they visit Polk Medical Center, the parent company of the local hospital and insurance provid- er have come to terms with one another.
Floyd Medical Center public relations officials announced the agreement reached between Polk Medical Center and BCBS on Friday afternoon. The deal will go into full effect on May 1, when patient coverage will begin officially.
“This is good news for those patients in our community who have Blue Cross Blue Shield, “Polk Medical Center Administrator Matt Gorman said in the hospital’s press release an- nouncing the deal. “This gives people the ability to access care locally, which will minimize time they have to spend away from family and work.”
The release quotes Gorman as giving credit for helping complete negotiations to State Rep. Trey Kelley, R-Cedartown, who was crucial in getting the issue resolved.
“Kelley helped hospital representatives gain access to key leaders at Blue Cross Blue Shield,” the release stated.
“Rep. Kelley has been an ally of ours throughout this entire journey,” Gorman said. “For him, it was as much of an effort on behalf of his own constituents as it was for the hospital. Without his support, I don’t know if this issue would have garnered the attention it deserved.”
“He is looking out for his community, and he knows it is important to access health care close to home,” Gorman added.
Kelley said he’s excited an agreement has been reached.
“This agreement will allow all those patients in our community who have Blue Cross Blue Shield to have access to their local hospital,” Kelley said. “I appreciate all the efforts of Polk Medical Center officials for getting this done. Polk Medical Center is a tremendous asset for our community and now even more residents of our community will get to benefit from the services they offer.”
The agreement between the hospital and insurance provider brings to close a long process of getting Blue Cross Blue Shield customers covered in-network when they visit Polk Medical Center for treatment. Prior to Floyd Healthcare Management taking over the hospital in 2013, HCA Healthcare, who owns Redmond Regional Medical Center, had recently reached a new deal with Blue Cross Blue Shield over repayments for care.
Negotiations began in 2013, and didn’t get far over the past few years as the two sides until a lawsuit was filed by the hospital in 2016 over reimbursements. At the time, the lawsuit claimed that Polk Medical Center was getting less in payments from BCBS in pursuit of “retaliation” for the Cedartown hospital not agreeing to what they felt were “unreasonable and unfair terms” to be part of the insurers network of providers.
Gorman said that lawsuit is still working its way through the court system, and is a separate issue from the contract the hospital signed with BCBS. He said additionally there has been a misconception about the process of the negotiation over the years, that Polk Medical Center and the insurance provider were both trying to hold out for the best deal.
“For more than two years we’ve offered what we felt were very competitive rates in the negotiation, well discounted from what Blue Cross Blue Shield is receiving at Floyd Medical Center in Rome,” Gorman said.
Gorman said he wasn’t at liberty to share any details of the agreement between the hospital and BCBS. “I’m glad that we have a deal,” he said. “In all of these contract negotiations, both sides usually have to give up something that they wanted.”
‘This agreement will allow all those patients in our community who have Blue Cross Blue Shield to have access to their local hospital. I appreciate all the efforts of Polk Medical Center officials for getting this done. Polk Medical Center is a tremendous asset for our community and now even more residents of our community will get to benefit from the services they offer.’
Rep. Trey Kelley R-Cedartown