Caring for Arizona’s kids goes far beyond the health care Phoenix Children’s provides today. We are growing to meet the needs of families and bringing the care you rely on closer to home.
We are also working with insurance carriers to advocate for contracts that ensure the specialized pediatric care you deserve isn’t being stripped away. Unfortunately, BlueCross BlueShield is refusing to put kids first.
Here’s what BCBS doesn’t want you to know about their offer to Phoenix Children’s:
BCBS’ offer would severely limit access to care
BCBS wants to move 50 percent of their members into restrictive, narrow plans by removing Phoenix Children’s from the state-wide PPO network. This would have a devastating impact on families and force them into limited coverage with providers who may not even specialize in pediatric care.
It would delay care by denying care
One of our greatest concerns is BCBS’s high rate of claim denials, including for medically necessary procedures like newborn care, which may delay your child’s care. We are simply asking BCBS to have an independent pediatric physician review these claims, but they have refused to even discuss this contract language.
BCBS could take it all away tomorrow
In addition to restricting access to its members, BlueCross BlueShield wants to make unilateral changes to the contract terms and rates after the contract has been signed. Even more troubling is that they want unilateral control to change anything in this contract, at any time. That includes only paying pennies on the dollar of their fictional $80 million over three-year offer, changing their mind on what services they deem appropriate for kids, and kicking specialists out of their network.
Fighting for a better deal for kids
Contracts should be partnerships, where both teams work together to ensure sustainable, quality healthcare for our growing community. BlueCross BlueShield walked away from these discussions before the contract deadline and hasn’t returned.
We understand it is challenging when health systems are out of network with your family’s insurance plan, but please know we are fighting for a contract that is in the best long-term interests of our patients.
| What you may have heard | What families should really know |
|---|---|
| BCBS claims they offered $80 million to stay in network. | FALSE. This number is fabricated and misleading. The offer is closer to half this amount, especially when factoring in denials. |
| BCBS claims they want to preserve kids’ access to pediatric experts. | FALSE. BCBS wants to move 50 percent of their members into restrictive, narrow plans that do not include Phoenix Children’s. |
| BCBS denies a high rate of medically necessary claims. | TRUE. 10 percent of services, and growing, representing $21 million annually are denied by BCBS resulting in delays that put your family at risk. |
| Arizona has a shortage of medical providers who specialize in pediatric care. | TRUE. BCBS wants to make this problem worse and restrict the number of doctors Phoenix Children’s can hire. |
| BCBS wants control to change anything in the contract, at any time. | TRUE. BCBS did this in August when they changed our rates and will do it again. This is an unreasonable restriction that no organization would entertain. |
Growing to care for even more kids
Phoenix Children’s has 8,000 employees dedicated to delivering care to your kids. Our nurses, doctors and staff treat some of the most complex pediatric conditions – from cancer and organ transplants to rare genetic and neurological conditions.
Families trust us to be at the ready with the highest quality, patient-centered care when they need us the most.
That is why we are opening more sites of care than ever before and delivering on our mission to advance Hope, Healing and the best Healthcare for children and their families.
See how we are growing a healthier community, together.
Have more questions?
If you have questions about your health plan, please call the BlueCross BlueShield phone number on the back of your insurance card. You can also review a list of frequently asked questions and answers here.