What Grady Not Taking Blue Cross Blue Shield Means For Patients
Grady Hospital is no longer accepting insurance from Blue Cross Blue Shield of Georgia, after the two sides couldn’t agree on a new contract last week. But what that means for patients depends on the treatment.
Grady is one of only two level-one trauma units in Atlanta. It’s one of two burn units in the state. And it recently opened a special unit for stroke care. Blue Cross Blue Shield will still cover emergencies in those centers.
It will still cover people who were already checked in to the hospital when the old contract ended, and some people may be eligible for continued benefits, including pregnant women in the third trimester. And physicians are still covered, so a regular doctor’s visit is OK, though lab tests resulting from a visit may not be covered.
What this really affects are scheduled surgeries, procedures and follow-up visits.
It’s not clear how many people will be affected.
The reason for the split is that Grady claims it’s not being fairly compensated for treatment. Blue Cross Blue Shield disagrees.
“We certainly recognize the level of care that Grady provides to this community,” said Blue Cross Blue Shield of Georgia spokesman Tony Felts. “We’ve offered fair reimbursement, and unfortunately that just hasn’t been enough.”
Democratic state senator Vincent Fort is one of the founders of the Grady Coalition, a group that advocates for Grady patients.
“I have not agreed with Grady administration in many instances, but in this instance, I think Grady’s patients are better served by Blue Cross Blue Shield increasing its payments to Grady.”
Both Grady and Blue Cross Blue Shield say they’re committed to continuing negotiations.
Officials with Grady declined to comment for this story.
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