The feud between Excellus Blue Cross Blue Shield and WellNow Urgent Care is intensifying as the end of the year approaches.
WellNow has threatened to stop accepting Excellus insurance after Dec. 31 if the company doesn’t agree to boost the rates it pays the provider.
“It's not completely about the money, it's about fairness, and also dignity and how we're being treated,” said Dr. Robert Biernbaum, chief medical officer for WellNow.
He said Excellus has cut the rates it pays the urgent care centers by 35% since 2016, and that’s leading the urgent care system to cut ties.
“It's hard to continue hearing from them, ‘Sorry, we can't do anything for you,’” Biernbaum said. “So we had to draw that line.”
The lower rate has made it difficult for the more than 70 WellNow centers across the state to properly staff their facilities, cover the cost of providers, and purchase supplies, Biernbaum said. The decision to stop accepting Excellus insurance will mostly be felt in small rural towns, he said, where WellNow is one of the only provider options.
“The choice is going to be between trying to get into a primary care (physician) who doesn't do all that we do, or waiting in an emergency department for six hours for something that we could have dealt with,” he said.
Biernbaum added that patients also can choose to pay the out of network cost for a visit, which may still be cheaper than going to the emergency room.
In a statement, Excellus called WellNow’s demands “unreasonable and counterproductive to its mission of keeping health coverage affordable.”
The urgent care facility is asking for a 60% rate increase, which Excellus said is significantly more than what they reimburse local doctors for similar services.
“Excellus needs to understand the service that we give in this community, and stop comparing us to services that we are not,” Biernbaum said. “The ball is in Excellus’s court.”
In its statement, Excellus said it would continue to engage in contract discussions with the urgent care system.
WellNow patients can visit www.urgentcarecounts.com for more information.
