Condell Insurance and Health Plans
Important Information for Blue Cross Members
| Blue Cross Blue Shield of Illinois (BCBS) members can continue their relationships with Condell Medical Staff physicians. Physicians contract with BCBS independently, and are not impacted by Condell's out-of-network status with Blue Cross Blue Shield of Illinois (BCBS). Physicians who participate in BCBS are considered in-network for office-based services. Please contact your personal physician or Blue Cross Blue Shield to confirm coverage for services. |
Condell Medical Center regrets to inform you that the ongoing contract disagreement between the hospital and Blue Cross has not been resolved.
We want to provide clear and accurate information to our patients. Please click on the first link below for more information regarding our Medicare patients. The second link lists all the other health plans accepted at Condell facilities.
*Medicare Patients Information
*Accepted Health Plans at Condell
Unfortunately, due to the contract dispute, Condell has had to make the very difficult decision to change billing and collection procedures for Blue Cross HMO and PPO members. At a court hearing held Tuesday, October 2, 2007, a judge upheld our right to make these changes.
The judge said that Blue Cross had breached its contract with Condell because Blue Cross cut off cash payments to Condell in June - an impact of approximately $25 million. Blue Cross has repeatedly and consistently claimed it did not stop paying the hospital and that it had a right to withhold payment. But the judge ruled that Blue Cross did withhold payment with no contractual or legal right to do so.
While Condell regrets having to hold patients responsible for payment, we were given no choice, as we can not continue to provide care without payment. The HMO and PPO contracts were legally terminated, and Condell is officially out-of-network/out-of-plan at this time. We encourage you to check with Blue Cross to ensure this is the case for your specific care.
In recognition of how difficult this situation is to its current patients, and due to the critical nature of care provided to those receiving infusion therapy, radiation oncology, cardiac rehabilitation, and Pediatric Alternatives in Creative Therapy (PACT), Condell will continue to accommodate the needs of patients who have been receiving these recurring services at Condell prior to October 2, 2007. Their treatments will not be affected by the contract dispute and will continue as scheduled.
Additionally, please note the following:
- Emergency services are not impacted and will continue to be covered as if in-network.
- Blue Cross HMO members assigned to CHCS (Site #320) are out-of-network as of November 1, 2007. HMO members should contact their primary care physicians to determine where to go for services.
- Medicare members who have private Blue Cross Medicare supplements (Medigap policy) are not impacted by the contract situation.
Condell Medical Center has been open and honest about the status of the contracts throughout the negotiation attempts. Condell recognizes and deeply regrets the impact of this situation on patients and their families.
If you have any questions about filing Blue Cross HMO or PPO claims, please contact your employer's human resources department, or Blue Cross Customer Advocates at 800-892-2803 (HMO) or 800-458-6024 (PPO).
Developing benefit choices for you is a priority at Condell. Realizing that the managed care plans being offered through local employers provide broad choices for employee benefit coverage, Condell Medical Center continues to work closely with the medical staff to ensure Condell options are also available to you.
For more information regarding your choices, call the Department of Managed Care at (847) 573-4175
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X - indicates this plan is available through Condell.
Note: The Managed Care Plan listing may change as new plans are added.
The definitions for the health plans are:
PPO (Preferred Provider Organization); HMO (Health Maintenance Organization); POS (Point of Service).
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