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Empire BlueCross BlueShield Patients To Lose Some Coverage At Northern Westchester Hospital

Negotiations between hospital's parent company and insurance company break down.

 

Stellaris Health Network, parent company of Northern Westchester Hospital and three other hospitals in Westchester County, announced today that it will drop some insurance coverage for Empire BlueCross BlueShield patients.

"Effective April 1, 2010, the Stellaris Health Network Hospitals, will no longer participate with Empire Blue Cross/Blue Shield," wrote Stellaris CEO Arthur A. Nizza in a public statement

In his letter, Nizza blamed Empire, a subsidiary of WellPoint, Inc., for not being able to come to an agreement over reimbursement rates. 

"The Stellaris Health Network Hospitals are asking no more from Empire than they already receive from other major payers in our area," Nizza wrote.

Nizza stated that Stellaris hospitals will continue to offer the following for people covered under Empire:

  • Emergency room coverage
  • Maternity and post-partum care for women in their second pregnancy trimester as of March 31.
  • Use of elective services through out-of-network benefits. This applies to people with Point of Service coverage and those under a PPO.
  • Treatment for "serious chronic conditions" and ongoing treatments such as chemotherapy for the next 90 days. 

Nizza also said that the hospitals will continue to bill Empire for services, regardless of coverage, but that they expect the insurance company to give payment to the patient instead. Because of this, Nizza wrote, "it is the patient's responsibility to forward payment in full to the Hospital."

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