Blue Cross Blue Shield is ending coverage at four Minnesota pain clinics
Center for Pain Management said it is trying to regain coverage.
ALEXANDRIA, Minn. -- Beginning Friday, Oct. 1, patients with Blue Cross Blue Shield of Minnesota insurance will have to pay out of their own pockets for visits to the Center for Pain Management, which has four Minnesota locations in Alexandria, Bemidji, Baxter and Sartell.
The clinic said it is trying to regain coverage for its patients, and that being outside the Blue Cross Blue Shield network of doctors will hurt patients who have limited options for care in the areas they serve.
"Access to our services has helped lessen the impact of the opioid epidemic and the COVID pandemic," wrote Jessie Keller, clinical services manager, to the Alexandria Echo Press in an effort to spread the word about the pending loss of a major insurance carrier. "Lack of access may result in a rise of opioid medication use, ER visit, and use of illicit drugs. We have provided our patients experienced, exceptional, and professional care through the years and feel limiting options will be detrimental to patients and overwhelm an already struggling system in these rural communities."
Through a spokesperson, Blue Cross Blue Shield of Minnesota confirmed that it is terminating its contract with the Center for Pain Management, but declined to provide a reason.
The company said it initially notified the clinic and its insurance customers that the contract would be terminated without cause effect Oct. 1.
"Upon further internal review of patient records, medical practices and billing information, Blue Cross submitted a revised termination notice – with cause – to Center for Pain management, effective October 1, 2021," wrote company spokesperson Bryce Butzer. "Due to peer review laws, we cannot disclose any details about the cause for termination at this time."
The company said it continually assesses its provider network "to ensure that all Blue Cross members have access to safe, effective and affordable care, and to verify that providers are billing appropriately for covered services."
It added that it will help its members find other nearby providers.
Keller said the Center for Pain Management was established in 2001 and has been in the Blue Cross Blue Shield network for 20 years with a good standing relationship. The clinic serves many underserved communities across greater Minnesota, she said.
The clinic was first notified on April 26 of the termination, then followed up with the insurer by mail and when it didn't hear back, followed up with a phone call, Keller said. At that point, the insurer's provider services told the clinic that its contract was current, she said.
"We then started hearing about our patients receiving letters of us becoming out of network end of Aug(ust)," she said.
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That started a back-and-forth dialogue with Blue Cross Blue Shield, which Keller said implied that the contract was renewed as of July 1. When the clinic asked why its patients were getting the letters about the termination, it received no reply until Sept. 9, Keller said.
Over the past six months, the Center for Pain Management has served 1,300 patients insured by Blue Cross Blue Shield, and 20% of its revenue comes from the insurer, she said.
Keller said other pain management clinics have voiced concern about the move, but Butzer said that no other pain management clinics have been removed from the Blue Cross network in the past year.
"Looking ahead, we will continue to evaluate our network to ensure our members are receiving safe, effective and appropriate care, and that providers are billing appropriately for services provided," he wrote.