Blue Cross Blue Shield subscriber needing surgery is caught in the middle of the battle with UMMC

JACKSON, Miss. (WLBT) - A woman in need of surgery is among the thousands caught in the middle of the battle between Blue Cross Blue Shield and the University of Mississippi Medical Center. Things may be getting worse for her and others. Negotiations between the insurance provider and hospital ended Friday to the disappointment of patients and the State Insurance Commissioner.

“It is a continuous growth,” said Jennifer Lott describing her extended right jaw. “I don’t know if it’s gotten worse or if it’s stayed the same.”

The Madison resident suffers from a genetic disorder that causes abnormal jaw growth. Blue Cross Blue Shield is her insurance provider, but her doctor is at the University of MS Medical Center. She’s been unable to have surgery there because of the disagreement over reimbursement rates. Ironically, the 26-year-old is the manager of the coffee shop at UMMC and can’t get treatment there.

“They tried to find someone within the network who could, you know, be a provider. There’s apparently no one in the state of Mississippi,” said Lott. “So they started sending me to Tennessee. After about a month and a half of that, they told me that the University of Tennessee will not take on my case.”

Lott is now being referred to doctors in Birmingham and Baton Rouge and won’t be reimbursed for travel if she is accepted for treatment. She isn’t alone. Insurance Commissioner Mike Chaney says 750,000 Mississippians are impacted. Friday, he suspended mediation between the insurance provider and the hospital after six weeks with no progress.

“I predict that we’ll probably have some type of agreement within the next few weeks, and if not, we’ll let the legislature and the governor decide what they want to do,” said Chaney.

The insurance commissioner said he has no authority to settle the matter and is concerned for cancer, transplant, and other patients currently needing treatment. Meanwhile, Lott has not been able to see a doctor for nearly a year.

“I’m not a transplant patient. I’m not high on the list,” said Lott. “I understand that, but at the same time, it makes me empathize with those who can’t get seen by doctors that are right down the street from them.”

Chaney said there has been no communication between BCBS and UMMC which resulted in his suspending the talks indefinitely.

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