San Antonio

Tenet Healthcare, which oversees Baptist Health System, is currently facing a contract disagreement with the insurance company Cigna.

Baptist Health has warned that if an agreement isn’t reached by the December 31 deadline, the 1.4 million Texas households that use Tenet facilities might face higher costs and interruptions in their healthcare services.

“If people lose in-network access to Baptist and other health systems, it could lead to financial difficulties and healthcare disruptions for many in our community,” remarked Bill Wachter, CEO of Baptist Health System.

If the negotiation standoff extends beyond the deadline, patients are advised to check their coverage. They can visit the Centers for Medicare and Medicaid Services for guidance.

Check if You Are Affected

It’s important to know that not all health insurance plans will be impacted by the disagreement.

If the conflict between Cigna and Baptist Health drags on past December 31, patients should reach out to both organizations to determine if they are affected.

Here are some questions to consider asking:

• Is (doctor’s name or location) currently considered out of network for my insurance plan?
• I have an appointment on (specific date). Is this considered in-network or out-of-network?
• Are in-network rates still valid for patients already receiving treatment?
• Will there be a payment plan, discount, or financial assistance if my costs go up?

It may be wise to jot down the names of the representatives you speak with and the date and time of the calls for future reference.

Ask if You Can Continue Treatment

Healthcare plans may provide continuity or transition of care policies for situations where a contracted provider is no longer in-network.

If you’re affected, it’s recommended to inquire with your healthcare provider about your eligibility for continued care. Here are some questions to pose to your insurance company:

• Where can I obtain the application form?
• What is the deadline to submit this request?
• If approved, how long is the service guaranteed to continue?

Consider Changing Plans or Providers

While disputes like these typically only last a short time, it’s worth considering whether to switch your healthcare plans if things drag on.

If your treatment is fairly routine, check with your insurance for in-network alternatives that might accept new patients.

You could also explore enrollment options through your employer or the Marketplace. Be sure to consult with your human resources department or Marketplace advisor about qualifying for a special enrollment period.

Wachter mentioned that Baptist Health System is offering free assistance for anyone looking to enroll in a Marketplace plan, which can be accessed by calling 210-202-5849.