Recent Network Provider Changes
April 1, 2022
The University of Mississippi Medical Center (UMMC) in Jackson, to include Batson’s Children’s Hospital, UMMC Grenada and UMMC Holmes County chose to terminate its Participating Hospital Agreements and Professional Provider Agreements with Blue Cross & Blue Shield of Mississippi (BCBSMS) effective April 1, 2022.
We have been trying to work with UMMC since early 2021 to renew their network agreement however, UMMC’s demands have made it very difficult to finalize an agreement. UMMC’s demands are not in your best interest as they will only unnecessarily increase your costs – and when it comes to your health, you should receive the best quality of care.
- UMMC is requiring significant payment increases and wants to be paid unrealistic amounts with an increase of more than 50% for certain services and an overall 30% increase.
- UMMC does not want to be measured on industry best practice quality like other Network Hospitals. Instead, UMMC wants to be measured “against themselves” based on fewer quality expectations.
- UMMC wants their providers to be paid more than other providers in the state.
UMMC will tell you UMMC needs to be paid more money to invest in their services and technology or because they treat more complex cases. Most of the services UMMC provides to Blue Cross Blue Shield patients can be provided by other Network Providers. Our payment to UMMC takes into consideration the complexity of the care and UMMC already receives significant state, federal and charitable funding.
Your health is important. Ensuring you have access to cost effective, quality healthcare is our commitment to you. It is important for you to know the following:
- In an emergency, you should seek care at the nearest available provider. Emergency services will be covered at Network-level benefits.
UMMC has acknowledged its obligation to provide continuity of care services at Network-level
benefits. Under continuity of care, patients can continue receiving their specialty services
(with Network benefits) through June 30, 2022. This includes:
- Patients receiving care from specialists because of a serious or complex condition,
- Patients admitted to a UMMC Hospital prior to April 1, 2022 and still in the hospital,
- Patients scheduled for non-elective surgery (to include post-operative care),
- Patients who are pregnant, or
- Patients with a terminal illness.
UMMC cannot balance bill you or require you to pay more (or upfront) for these services. BCBSMS will continue to provide Network-level benefits.
Blue Cross Blue Shield Network Providers across Mississippi, and in surrounding states, are available to ensure access to quality care for you and your family. If you need care for elective services or desire to transition to a non-UMMC provider, please contact our Customer Team at 1-800-898-7797.
If you receive any services at UMMC, you should also understand your rights to instruct BCBSMS where to send your benefit payment. You may provide Blue Cross & Blue Shield of Mississippi with direction of payment instructions to make your Network-level benefit payment for covered services to UMMC. UMMC should accept your benefit payment and not bill you for any amount other than any deductible and coinsurance/copay.
If UMMC refuses to schedule an appointment, requests you pay upfront in full for services, charges you greater than your Explanation of Benefits or requires you to file a claim, please contact our Customer Team at 1-800-898-7797.