Local pediatricians feel impact of UMMC vs. Blue Cross Blue Shield legal battle

JACKSON, Miss. (WLBT) - Mediation between UMMC and Blue Cross Blue Shield continues for another month while parents with sick children are stuck trying to find new ways to get them care.

Thousands of Blue Cross Blue Shield patients needing to see UMMC specialists seem to have their hands tied since the two organizations’ legal battle began in April.

Local pediatricians said they are dealing with the fallout.

“Our referral coordinators got a lot of calls about what patients could do to get their follow-up appointments,” Dr. Darren Scoggin with Children’s Medical Group said.

Pediatric groups in the area said they’ve adjusted treatment plans because of the ongoing battle, specifically when it comes to referrals.

“Because Batson Children’s Hospital is the only children’s hospital in the state, we require a lot of specialty services for pediatrics there,” Dr. Scoggin explained.

At Children’s Medical Group in Jackson, two referral coordinators are working hard to find BCBS patients new providers in the area.

“We have a dedicated referral specialist who can navigate that system because there’s a lot of paperwork involved, a lot of phone calls involved, and a lot of time spent with both patients and referral centers, whether that’s UMMC or private centers,” Dr. Scoggin said.

However, because the Children’s Hospital is the only place in the state many patients can get needed care, referral coordinators are searching a little more for places that are within reach.

“Patients that are out of network at UMMC have the option of paying out of pocket or appealing to their insurance company, but if we can’t get that, we’re happy to help them to look around for other pediatric specialists, either in the state or out of the state,” Dr. Scoggin said.

Pediatricians said despite the mediation, both organizations are helping them find ways to get care to patients.

“A lot of the specialists at UMMC have worked really well with our patients proactively to get them either refills that they need until this is resolved or try to figure out a way to get the visit covered if needed until the arbitration is through and Blue Cross and UMMC can come to an agreement,” Dr. Scoggin said.

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