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Yes, Blue Cross Blue Shield has a protocol in place for reviewing requests to cover care at Methodist Le Bonheur Health

The insurer says members should reach out prior to any scheduled services so they can discuss their options.

MEMPHIS, Tenn. —

If you're insured by Blue Cross Blue Shield of Tennessee, you may be among thousands worried about the insurance company's recent break-up with Methodist Le Bonheur Healthcare.

But even though their relationship ended with the new year coverage some are saying you can still get an extension at Methodist locations. 

THE QUESTION

Is there a 90-day grace period or extension for patients at Methodist Le Bonheur Healthcare locations that are insured by Blue Cross Blue Shield?

THE SOURCES

THE ANSWER

This needs context.

Yes, Blue Cross Blue Shield has a protocol in place for reviewing requests to cover care at Methodist Le Bonheur Health as in network. But it is a process that varies and members must reach out.  

WHAT WE FOUND

In total, 11 locations have been removed from Blue Cross Blue Shield of Tennessee networks, including Blue Network P, Bluecare Tennessee, TennCare Select, Cover Kids, and The Dual Special Needs Plan:

  • Methodist University Hospital - 1265 Union Ave, Memphis

  • Methodist Healthcare – Germantown  - 7691 Poplar Ave, Germantown

  • Methodist Healthcare – North Hospital - 3960 New Covington Pike, Memphis

  • Methodist Healthcare – Olive Branch Hospital - 4250 Bethel Rd, Olive Branch

  • Methodist Healthcare – South Hospital - 1300 Wesley Dr, Memphis

  • Methodist Blood and Marrow Transplant Center - 2 Shorb Tower, 1265 Union Ave, Memphis

  • Methodist Comprehensive Breast Center – Germantown and Midtown locations - 1381 S Germantown Rd, Germantown & 1801 Union Ave, Memphis

  • Methodist Le Bonheur Children’s Hospital - 848 Adams Ave, Memphis

  • Methodist Le Bonheur Germantown  - 7691 Poplar Ave, Germantown

  • Methodist Le Bonheur Germantown Surgery Center - 1363 S Germantown Rd, Germantown

  • Wolf River Surgery Center (effective Oct. 23, 2023) 

Methodist Le Bonheur Healthcare referred us to Blue Cross Blue Shield for details on coverage and extensions for any patients.

BCBS says they have protocols in place for reviewing requests to cover care at Methodist or Le Bonheur as in-network. It’s a process they say they’ve used with some members so far. 

But on a case-by-case basis, the insurer says members should reach out prior to any scheduled services so they can discuss those options.

BCBS didn’t specify any particular exceptions or exemptions but in a statement to ABC24 they said, in part, “... We are negotiating with the larger methodist system, we offered a separate contract to keep Le Bonheur in-network. And we aren’t asking for Methodist to accept lower payments for TennCare patients who are Bluecare members.”

Related

What Methodist's split with Blue Cross Blue Shield of Tennessee means for those under their coverage

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