Important information for patients with health insurance through Blue Cross and Blue Shield.
Baylor Scott & White Health (BSWH) is currently negotiating a new contract to cover care for patients with Blue Cross and Blue Shield (BCBS) health insurance.
We are pleased to share that we have reached an agreement with Blue Cross and Blue Shield to extend provider and facility contracts to Oct. 1, 2024.
The three-month extension means BSWH providers and facilities will remain in network for BCBS members while we continue work to finalize a longer-term agreement.
Your well-being is our priority. If you have canceled an appointment or procedure, please reschedule by accessing MyBSWHealth, visiting BSWHealth.com/Appointments or calling 833.889.2464. You may also call your provider's office directly.
Thank you for trusting us with your healthcare needs.
Frequently asked questions
-
How does this impact Baylor Scott & White patients?
Patients should continue to visit Baylor Scott & White hospitals, facilities, and providers as they normally would. If an agreement is not reached by Oct. 1, 2024, Blue Cross and Blue Shield (BCBS) will be considered out of network for care delivered by Baylor Scott & White Health (BSWH) doctors and facilities for most BCSB members. This could mean increased costs for BCBS patients who want to continue receiving care from a BSWH facility or provider.
-
What if I have an appointment with my Baylor Scott & White provider scheduled on or after the date the agreement ends?
At this time, we’re advising patients to keep the appointments they have scheduled on or after Oct. 1, 2024. Canceling services could delay care, and it may not be necessary if an agreement is reached before the current contract expires. In addition, some patients may be eligible for Continuity of Care through BCBSTX. (A link to BCBSTX’s Continuity of Care form can be found at the top of this webpage.)
-
What if I am receiving treatment for a special condition on or after the date the agreement ends?
If an agreement is not reached by Oct. 1, 2024, some services may still be covered for a short period of time if they already began and are not yet complete. However; we encourage patients to talk with their medical team if they have clinical questions about their care. Certain patients, including those who are hospitalized or undergoing an active course of treatment before the contract end date, may qualify for Continuity of Care through BCBSTX. If you think you may qualify, call the phone number on the back of your BCBSTX health insurance card today to request a Continuity of Care form and apply.
If you wish to request continued access, a Continuity of Care form can be found on BCBSTX’s website. Check the second box and look for your BSWH provider’s contact information here. (Note: The form asks for an “NPI ID #.” This is a National Provider Identifier consisting of a unique 10-digit number for your provider. You can find the number by searching the national provider database.)
The Continuity of Care form may be faxed or mailed to BCBSTX for consideration. Because BCBSTX approves and denies requests, BSW cannot provide status updates. If you obtain approval for Continuity of Care from BCBSTX, please share the letter with your provider.
-
What if I have a medical emergency on or after the date the agreement ends, and Baylor Scott & White is out of network?
If you experience a medical emergency, you should always visit the nearest emergency department. BCBS will pay for services you receive to evaluate and stabilize an emergency medical condition, regardless of whether your care is received from an in-network or out-of-network emergency department.
-
Which plans are included in this negotiation?
BCBSTX Medicare supplement plans are not included in this negotiation. The following plans are included in this negotiation:
- ParPlan
- Health Select
- Blue Choice PPO
- Blue Essentials
- Blue Advantage HMO
- Blue Premier / High Performance Networks (HPN)
- Blue Cross Medicare Advantage (PPO)
- Blue Cross Medicare Advantage (HMO)
- Managed Medicaid STAR Kids
For Providers Epic Code Plan Name 421520 BLUE CROSS BS HEALTH SELECT OF TEXAS 421550 BCBS OF TX BLUE PREMIER 421553 BLUE ESSENTIALS/HMO BLUE TEXAS 421556 TRANSPLANT BCBS PPO 421558 BCBS OF TX PPO/POS 421559 BCBS OUT OF STATE 421561 LIMITED PYMT INS BLUE CROSS 421564 MYBLUE HEALTH OON 421565 BCBS OF TX PPO CITY OF DALLAS 421566 HIGH PERFORMANCE NETWORK 421567 BCBS OF TX PPO TEXAS A&M 421568 CITY OF DALLAS PPO TRANSPLANT 421569 BCBS FEDERAL 220501 BCBS TX STAR 220504 BCBS - STAR KIDS 220506 BCBSTX MEDICAID 220507 BCBS CHIP 404950 BCBS OF TX MCARE ADVANTAGE 404951 TRANSPLANT BCBS MEDICARE GENERIC 404952 BCBS MCARE ADVANTAGE 84980 404954 BCBSTX MEDICARE ADVANTAGE GROUP RETIREE 132601 BCBS BLUE ADVANTAGE PPO EXCHANGE 132602 BCBS BLUE ADVANTAGE PPO TRANSPLANT EXCHANGE 136101 BCBS BLUE ADVANTAGE HMO TRANSPLANT EXCHANGE 136102 BCBS BLUE ADVANTAGE HMO EXCHANGE 136103 TRANSPLANT BCBS OOS 136104 TRANSPLANT BCBS HMO -
Which facilities are impacted?
All Baylor Scott & White locations, including hospitals, urgent care, imaging centers, ambulatory surgery centers and free-standing clinics are included in this negotiation.
The negotiation also includes the following sites affiliated with Baylor Scott & White Health: Hospital - Surgical North Central Surgical Center Surgery Centers Bear Creek Surgery Center
Lone Star Endoscopy
North Texas Surgery Center
Park Cities Surgery Center
Sherman Endoscopy Center
SurgCenter
Texas Endoscopy
Tuscan Surgery Center at Las Colinas
Free-Standing Imaging Centers Advanced Imaging Center
Blue Star Imaging at The Star
Urgent Care Centers NextCare -
Does this negotiation apply to Blue Cross and Blue Shield plans from other states?
Yes. BCBSTX negotiates network contracts on behalf of all Blue Cross and Blue Shield plans. Patients with a policy from an out-of-state Blue Cross and Blue Shield plan utilize the BCBSTX network.
-
How are pharmacy benefits impacted?
Pharmacy benefits are part of a separate contract and are not impacted by this network negotiation.
-
Who is eligible for Continuity of Care?
BCBSTX approves or denies requests for its members to receive Continuity of Care. It lists the following as potentially “applicable” for Continuity of Care:
- Pregnancy or undergoing a course of treatment for pregnancy
- Surgery scheduled or recently performed
- Scheduled for nonelective surgery
- Postoperative care
- Transplant list
- Undergoing a course of treatment for a serious and complex condition
- Undergoing institutional or inpatient care from the provider
- Having been determined to be terminally ill