Frequently Asked Questions
What is happening between AMG and BCBSTN?
BCBSTN recently notified AMG that they intend to terminate our current contract if we do not agree to dramatic rate cuts. If we are not able to reach an agreement on a new contract by September 1, 2018, we will be considered out-of-network providers for patients with BCBSTN commercial insurance. We are currently negotiating in good faith with BCBSTN, and hope to reach a fair agreement on a new contract before there is any disruption in our patients’ care or change in financial responsibility.
Why is BCBSTN terminating the contract?
BCBSTN has made claims that we are 2-3X more expensive than other anesthesia groups. Not only is that not true, but Blue Cross has since admitted this claim is inaccurate. They are also not considering the rising cost of living for our staff, CRNAs, and physicians in Nashville. Finally, BCBSTN is trying to reduce the cost of anesthesia services (period), and are looking for AMG to help them do that without regard for the impact to quality and access.
When will AMG be considered out-of-network?
If we are unable to reach an agreement by September 1, 2018, our current contract will terminate immediately and we will be considered out-of-network providers. We are negotiating with BCBSTN in good faith, and are committed to reaching an agreement before there is any disruption in care for our patients.
Why can’t AMG reach an agreement with BCBSTN?
The rate cuts that BCBSTN is demanding are simply not sustainable for AMG, or any other medical group. We are committed to providing the highest quality anesthesia care at an affordable price for our patients, and we refuse to put that care, or our relationships with our hospital and physician partners, at risk by entering into an unfair contract with BCBSTN.
What does this mean for patients who receive care using an anesthesiologist from AMG?
If we ultimately do become an out-of-network provider on September 1, we will work with our patients in every way we can. We will continue to expect our current in-network rates from BCBSTN and the patients and no more. For the patient responsibility portion, we will continue to work with the patients and offer financial hardship discounts, early pay discounts, and payment plans.
Will my care be more expensive?
Yes. If we become an out-of-network provider on September 1st, your cost of care will likely be higher and could be significantly higher as BCBSTN is shifting the payment responsibility from themselves, as the insurer, to you, the patient. BCBSTN will save money by shifting more costs to you rather than provide the in-network coverage your premiums are intended for.
We will work with patients in every way we can to assist in financial responsibility through financial hardship discounts, early payment discounts, and payment plans. However, we can’t be sure exactly what payments for our services will look like until we see how BCBSTN ultimately pays our claims, but we will do everything we can to protect our patients.
Will my surgeon also be considered out-of-network?
If we become out-of-network providers on September 1, only AMG physicians and CRNAs will be affected. Your surgeon, and other physicians involved in providing your care, will not be affected by our negotiations will BCBSTN.
Will my hospital or surgery center be considered out-of-network?
If we become out-of-network providers on September 1, only AMG physicians, CRNAs, and staff will be affected. Your hospital will not be affected by our negotiations will BCBSTN.