SAN MARCOS, TEXAS
- After several months of negotiations, Central Texas Medical Center (CTMC) will no longer be part of the Blue Cross Blue Shield of Texas (BCBSTX) network, effective April 7, 2014. CTMC offered to accept a proposal by BCBSTX provided the company would agree to engage a third-party to confirm that the PROPOSED rate for the services were fair and in line with what BCBSTX pays other hospitals for the same services. Unfortunately, BCBSTX rejected the offer and chose to let the contract end, impacting thousands in the community.
“This is certainly not the outcome we wanted, but we remain fully committed to working with our patients to continue providing the care they need through their local, community hospital,” said Sam Huenergardt, president and CEO of CTMC. “We are working diligently to help BCBSTX members understand their options and ensure a smooth transition.”
Because CTMC is now a non-participating provider, in-network access for BCBSTX members has changed.
• Every BCBSTX member has access to emergency services and care at CTMC and 24/7, at in-network benefit levels, regardless of their benefit plan.
• Many BCBSTX plans offer benefits for out-of-network elective services. Members can call the number on the back of their insurance card to verify their out-of-network benefits.
• CTMC has participation agreements with many other health care companies in the area. Please visit www.ctmc.org/patients-visitors for a list.
The key issue in the contract negotiation was BCBSTX’s history of underpaying CTMC. The hospitals have not received a rate increase from BCBSTX in a number of years, yet cost to provide health care continues to increase.
“We know this situation can be stressful and we are here to help,” said Huenergardt. “We appreciate your patience and support during this time and we will continue to pursue a resolution that will allow BCBSTX members to continue to access CTMC on an in-network basis.”
If a BCBSTX member has questions or needs help understanding their options, please call (512) 753-3894 or visit www.ctmc.org
.Please click here to view a list of Frequently Asked Questions.
The hospital, which originated in 1923 as Hays County Soldiers, Sailors and Marines Memorial Hospital, was restructured in 1960. The present facility was opened at its current Wonder World Drive location in 1983. The CTMC staff of more than 700 employees works with more than 220 active and consulting physicians to provide quality services to patients and their families.
In addition, over 200 community members and interns from area educational institutions volunteer their services to the hospital. In 2010, 2011, 2012 and 2013, CTMC was named The Best Hospital in Hays County. CTMC also added a certified Chest Pain Center to its ER capabilities in 2011 and became an accredited Primary Stroke Center in 2013. In 2012, CTMC became the first operating room along the IH-35 corridor between Austin and San Antonio to be equipped with a da Vinci robotic-assisted surgery suite.
CTMC is a member of the Adventist Health System (AHS), a not-for-profit healthcare organization that emphasizes Christ at the center of care. Founded in 1973, Adventist Health System is a national leader in quality, safety and patient satisfaction. Today, Adventist Health System supports 45 campuses in 10 states and employs nearly 70,000 individuals. Adventist Health System hospitals are comprised of more nearly 8,300 licensed beds, providing care for 4.5 million patients each year in inpatient, outpatient and emergency room visits.