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Information on Phoenix Children’s contract with Blue Cross® Blue Shield® of Arizona

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If Blue Cross® Blue Shield® of Arizona (BCBSAZ) is the current insurance carrier for you or your child, a possible change to Phoenix Children’s agreement with BCBSAZ may affect your ability to receive in-network services from Phoenix Children’s after December 1, 2021.

Health systems like Phoenix Children’s periodically update agreements with health insurance companies and Phoenix Children’s is currently in such discussions about a new agreement with BCBSAZ. Unfortunately, if an agreement is not reached by December 1, 2021, Phoenix Children’s will no longer be a contracted provider with BCBSAZ.

That means the care you or your child receives from Phoenix Children’s, as well as our physician providers and urgent care centers, would be considered out-of-network as of December 1, 2021, and you might see changes in your financial responsibility for care received at Phoenix Children’s. 

Phoenix Children’s will continue to work with BCBSAZ over the coming weeks to reach an agreement so that we may avoid any disruption to the exceptional care you’ve come to expect from us.

If you have questions about your benefits or wonder how you can help avoid this disruption, please contact BCBSAZ directly. Or, speak with your benefits manager/employer and make them aware of your concerns.

Frequently Asked Questions: Phoenix Children’s/Blue Cross® Blue Shield® of Arizona Contract Negotiation

I have a Blue Cross® Blue Shield® of Arizona (BCBSAZ) health plan. What does this mean for me?

Nothing is changing for you until December 1, 2021, as negotiations between Phoenix Children’s and BCBSAZ have been ongoing. If an agreement cannot be reached by the termination date of December 1, 2021, all Phoenix Children’s providers, including Phoenix Children’s Hospital, Phoenix Children’s Medical Group, Phoenix Children’s Pediatrics and Phoenix Children’s Urgent Care locations will be out-of-network for all patients with BCBSAZ insurance or with insurance that uses the BCBSAZ network.

Why haven’t Phoenix Children’s and BCBSAZ come to an agreement yet?

We are working to remain in-network with BCBSAZ but have not reached a new agreement yet.
Phoenix Children’s is focused on reaching an agreement that allows us to continue providing highest quality of care to our growing community as patient families deserve exceptional pediatric care close to home.

If BCBSAZ is out-of-network, how will my access to your providers change?

If termination occurs, on or after December 1, 2021, Phoenix Children’s and BCBSAZ will no longer be contracted. This means you may no longer have in-network benefits with our providers. You may continue to access our health care providers and hospitals for health care services as follows:

  • Emergency Care: Emergency care access is not impacted. You may continue to receive emergency care at our Emergency Room, regardless of our network status with BCBSAZ.
  • Continuity of Care: Certain patients may be eligible to receive “Continuity of Care” benefits with BCBSAZ for a period of time if they need ongoing treatment or already have a procedure scheduled. For questions about ongoing care or benefits coverage, please call the phone number listed on the back of your BCBSAZ insurance card.
  • Out-Of-Network Care: You may still access our health care providers and hospitals for health care services if you have an out-of-network benefit. In some situations, depending on the type of service BCBSAZ authorizes, in-network benefits may be available if alternative providers are not available in the service area. Please call the number listed on the back of your insurance card to discuss your specific in or out-of-network benefits with BCBSAZ.

Which BCBSAZ products are affected by the contract termination?

BCBSAZ products likely affected by the contract termination include Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans and Indemnity Plans. To discuss your specific plan and how it may be impacted, please call the number listed on the back of your insurance card to review your specific in or out-of-network benefits with BCBSAZ.

Which providers are affected by the contract termination?

Phoenix Children’s Hospital, Phoenix Children’s Medical Group, Phoenix Children’s Pediatrics and Phoenix Children’s Urgent Care Centers, will be out of network if agreement is not reached with BCBSAZ by December 1, 2021.

Will I have to pay more money out-of-pocket to receive care now that you are an out-of-network provider?

Please call the number listed on the back of your insurance card to discuss your specific in or out-of-network benefits with BCBSAZ. Phoenix Children’s also offers self-pay options, and you are welcome to access our services as a self-pay patient. Call our financial counselors to facilitate an estimate at (602) 933-2000.

What action can I take to ensure I continue to have access to in-network services at Phoenix Children’s under BCBSAZ?

To ensure Phoenix Children’s continues to be in-network, talk to your insurance carrier, BCBSAZ, or your benefit manager directly to stress the importance of having in-network access to Phoenix Children’s.

What if I have a doctor’s appointment or elective procedure scheduled after December 1, 2021?

We understand you may already have appointments scheduled on or after December 1, 2021. If this is the case, you may qualify for Continuity of Care benefits for a period of time if your child needs ongoing treatment or if you already have a procedure scheduled. For any questions about your BCBSAZ Continuity of Care benefit coverage, call the customer service phone number on the back of your BCBSAZ health insurance card.

You may still access our health care providers and hospitals for health care services if you have out-of-network benefits. In some situations, depending on the type of service BCBSAZ authorizes, in-network benefits may be available if alternative providers are not available in the service area. Please call the number listed on the back of your insurance card to discuss your specific in or out-of-network benefits with BCBSAZ.

What if I have an emergency?

Emergency care access is not impacted. Patients may continue to receive emergency care at our Emergency Room, regardless of our network status with BCBSAZ.

How long will Phoenix Children’s be an out-of-network provider?

At this time, it is difficult to determine how long we may be out of network. We have kept the lines of communication open with BCBSAZ. We recognize and value our relationship with our patients and remain open to discussions with BCBSAZ to continue to work to reach an agreement.

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