BILLINGS - Billings Clinic and Blue Cross Blue Shield of Montana are currently negotiating medical service reimbursement rates with a deadline looming.
According to a letter signed by Billings Clinic CEO Dr. Clint Seger, the current reimbursement contract between the hospital and the insurance provider expires on March 31, 2025.
"We are asking to be paid fair market reimbursement for the services we provide for our patients who are insured by Blue Cross Blue Shield of Montana," the letter states. "Many hospitals across the nation are losing money or barely breaking even because the cost of providing care is becoming unsustainable, due in part to rising inflation and not being paid at market reimbursement rates."
April Staudinger received this letter on Tuesday. She is just one of the roughly 40,000 households this could impact.
“Shock, simply because I have one physician that I've gone to for over 25 years and he's in the Billings Clinic,” Staudinger said on Wednesday.
Staudinger had a defibrillator placed in 2015 and has multiple specialty doctors at Billings Clinic.
"I would probably end up paying out-of-network costs simply because I don't want to have to take all of those records and transfer them to another physician's office," she said. "I appreciate and respect the fact that they sent the letter. That was the first time that I had heard of anything. Not that we have any control over the situation, but it's life-changing for some people."
Seger reiterated what the letter states during an interview with MTN News on Tuesday: The hospital hasn't increased its rates in 10 years, but with the cost of inflation, many hospitals across the nation are struggling.
“There's a point at which the keeping our rates flat for 10 years starts to have an impact and so we really need to make a change in their contracts to make sure we are appropriately reimbursed so we can continue that care,” Seger said. “A number of health care organizations are struggling and there's a number of reasons for that. You know, the increased inflationary costs to deliver health care, costs for labor. And then part of that is some of the struggles that we see are how we're reimbursed.”
Seger said they don't want to have any disruption to patient care or cause any uncertainty.
The hospital and insurance provider are in "good faith" negotiations, but if a new contract is not reached by the deadline, the cost of patient care could be affected.
"It's possible that after the end of March, if we didn't have a new contract that it would impact patients, the cost of care for them or their choices for providers through Billings Clinic. And so that's why we're obviously taking this very seriously and our negotiations are really important," Seger said.
"If an agreement is not reached by March 31, this could limit your choices of doctors and hospitals, disrupt your care at Billings Clinic and bring higher costs for your care here," the letter states.
In a statement to MTN News from Blue Cross Blue Shield of Montana, a spokesperson said they are advocating for customers to have fair prices.
"We have a long-standing and positive relationship with Billings Clinic. Billings Clinic currently remains in-network and we are negotiating a new contract to be effective April 1, 2025. Our customers and members trust us to protect and keep their health care costs as low as possible. It’s a responsibility we take very seriously. We’ll continue to negotiate on behalf of Montanans we serve and hope to reach an equitable agreement with Billings Clinic," the statement said.
For now, Blue Cross Blue Shield of Montana remains an in-network provider.
