Doctor explains why he will not accept new state health insurance

Doctor explains why he will not accept new state health insurance

AMARILLO, TX (KFDA) - Local doctors are continuing to work with one major insurance provider after area policy holders say it is preventing them from getting the medical care they need.

Blue Cross Blue Shield HealthSelect is the new insurance plan all state employees were given on September 1st.

Some doctors in our area are now sharing they will not take this new plan because they said the reimbursement rate is so low they would not be able to stay open if they joined that network

Dr. William C. Biggs is an endocrinologist and the Managing Partner for Amarillo Medical Specialists, which is one medical office that is not accepting HealthSelect.

He said the reimbursement rates the plan offers them are so low (about at or even below the Medicare level) that they would not make enough money to continue to provide help to their patients.

"You can't keep the lights on and pay your staff to provide the level of service that we want to give," said Biggs.

Biggs said he has been talking with Blue Cross to try and change their fee schedule so his group of doctors can be in network for state employees.

That includes both specialists and primary care doctors that patients are losing access to.

"The people that you're letting go here are the people that are doing a really good job for you," said Biggs. "It makes no sense."

One of those patients with state healthcare is Gerri Terry, who sees her primary care doctor and endocrinologist at Amarillo Medical Specialists.

She received a letter from them explaining why they would not accept her new insurance.

"I definitely understand their point of view," said Terry. "I don't think that it's fair that the insurance companies expect them to... They're low-balling the doctors."

Terry said she's starting to worry about finding a new endocrinologist, who she needs to see frequently as a diabetic patient.

"I've also found out that there are no, not one endocrinologist in Amarillo that's accepting this plan, so I'm not sure," said Terry. "I really don't know what I'm going to do about that."

Biggs said he has not heard from Blue Cross in about a week, but hopes they can work something out that will not harm providers or policy holders.

"We love our patients," he said. "We want to continue working with our patients... But at the same time be able to keep our lights on and be able to recruit new doctors that will continue these same initiatives."

Other doctors in our area are also trying to negotiate with Blue Cross for what Biggs said are more reasonable reimbursement rates.

Local politicians, like State Senator Kel Seliger, are also trying to fix the problem for state employees.

At this point Blue Cross has declined to comment.

We will update you if any changes are made.

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