Arizona Health Insurer, Medical Provider In Contract Spat

Arizona Health Insurer, Medical Provider In Contract Spat

Contract disputes in the business world frequently feature a major dose of I-say, you-say accusations bandied back and forth between commercial parties that are at odds contractually.

Unsurprisingly, major contractual discord between one of Arizona’s largest medical insurance companies and a health group that provides medical services in the Phoenix metro area and elsewhere across the state is no different.

Which means this: the mud is being slung.

Blue Cross Blue Shield of Arizona, which enrolls approximately 1.4 million members statewide, and the Abrazo Community Health Network, have reportedly been negotiating contractual terms and conditions throughout most of 2015.

As noted in a recent article discussing their relationship, progress has been elusive.

In fact, the parties’ relationship now seems mired in reciprocal name calling.

The insurer states that it will denote Abrazo as an out-of-network provider come next year unless the company pares down unreasonable payment demands for hospital services rendered to Blue Cross clients.

For its part, Abrazo counters that the insurer is focused more on profit making than it is on providing good services to its members, and to an unseemly degree. In fact, Abrazo recently ran an ad in an Arizona paper reporting that BCBS has accrued near $670 million in excess profits over the past several years.

Blue Cross contends that Abrazo is grossly overcharging for services. Abrazo responds that Blue Cross pays the health system’s hospitals less than it does other facilities in the same market.

“Just get us closer to what the average fair market rates are in Phoenix,” says an Abrazo executive.

The clock is clearly ticking on this dispute, with the out-of-network classification scheduled to kick in from January 1, 2016, in the event the two companies cannot reach agreement.

Call Cook & Price, PLC today at 480-407-4440 or email us through this website.

2017-09-28T05:48:55-07:00 December 23rd, 2015|Categories: Contract Disputes|Tags: |

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