You are affected by Blue Cross Blue Shield terminating Springfield Clinic as an in-network provider if you are a member of:

  • Blue Cross Blue Shield commercial plans
    • Out-of-network coverage for the Ambulatory Surgery Center effective Aug. 19, 2021
    • Out-of-network coverage for all Springfield Clinic providers effective Nov. 17, 2021
  • Blue Cross Blue Shield Choice
    • Out-of-network coverage effective July 1, 2021
      While Blue Cross Blue Shield Choice Members are out of network July 1, Blue Cross Blue Shield ultimately decides whether to process a claim at the in-network or out-of-network rate. We recommend that patients call the phone number on the back of their member cards to determine which network rate will apply to the visit/procedure/service. 

You are not affected by Blue Cross Blue Shield terminating Springfield Clinic as an in-network provider if you are a member of: 

  • Blue Cross Community Health Plan
  • Blue Cross Blue Shield Medicare Medicaid Alignment Initiative (MMAI) HMO
  • Blue Cross Blue Shield Medicare Advantage HMO plan offered via Physician Health Association of Illinois (PHAI)

 


 

Frequently Asked Questions Regarding Blue Cross Blue Shield PPO Developments

Why is Springfield Clinic no longer participating with BCBS PPO plans?

Springfield Clinic has been notified that Blue Cross Blue Shield will be terminating all existing commercial PPO plans for Springfield Clinic providers at all locations. If you have one of these plans, this means that, after the effective dates below, Springfield Clinic will be an out-of-network provider for your BCBS plan. There are some Medicare/Medicaid plans that are exceptions.  

We will continue to provide your patient care, however it would be through your plan’s out-of-network coverage.

Effective Aug. 19, 2021, Springfield Clinic will be out-of-network for all procedures scheduled at our Ambulatory Surgery and Endoscopy Center (ASC). If you have a procedure- currently scheduled for after Aug. 19, 2021, Springfield Clinic ASC staff will be contacting you to discuss your surgery options. 

Effective Nov. 17, 2021, BCBS will be out-of-network for primary, specialty and urgent care and all additional medical services and lab services at all Springfield Clinic locations.  

We urge you to review and understand your plan’s benefits and review other options. We regret that this may impact you, and we are attempting to work with Blue Cross Blue Shield to resolve this matter. 

Why was this decision made?

Blue Cross Blue Shield made this decision without consulting us, and we were not given advance notice of the termination. 

When does the termination of the Blue Cross Blue Shield PPO plans take effect?

Effective Aug. 19, 2021, Springfield Clinic will be out-of-network for all procedures scheduled at our Ambulatory Surgery and Endoscopy Center (ASC). If you have a procedure- currently scheduled for after Aug. 19, 2021, Springfield Clinic ASC staff will be contacting you to discuss your surgery options. 

Effective Nov. 17, 2021, BCBS will be out-of-network for primary, specialty and urgent care and all additional medical services and lab services at all Springfield Clinic locations.  

What can I do about BCBS not covering services at Springfield Clinic? What are my options?

  • If your employer offers other health plan options, we urge you to consider switching to another plan that includes Springfield Clinic as an in-network provider during your upcoming enrollment period. 
  • You can review a list of the plans that include Springfield Clinic as an in-network provider here: www.springfieldclinic.com/insurance
  • If you are currently undergoing treatment, Continuity of Care, a temporary extension of coverage, may be available for you. Continuity of Care is coordinated and administered by Blue Cross Blue Shield, and we will do everything we can to support you, if you need this coverage. Please contact BCBS at the phone number on the back of your member card, or your employer’s benefit administrator, to obtain information about how to continue in-network coverage for your current treatment.  

Can I still see my Springfield Clinic doctor if I have Blue Cross Blue Shield insurance?

Yes, but you should review the benefits and what your out-of-network costs will be for you under your Blue Cross Blue Shield PPO plan. Springfield Clinic participates with fourteen commercial plans to provide the exceptional care you and your family expect and deserve from your providers at Springfield Clinic. The complete list of in-network plan choices can be viewed on our website at www.springfieldclinic.com/insurance.

How can I tell if my plan is affected?

Springfield Clinic has been notified that Blue Cross Blue Shield will be terminating all existing commercial PPO plans for Springfield Clinic providers at all locations. If you have one of these plans, this means that we will continue to provide your patient care, however it would be through your plan’s out-of-network coverage.

Effective Aug. 19, 2021, Springfield Clinic will be out-of-network for all procedures scheduled at our Ambulatory Surgery and Endoscopy Center (ASC). If you have a procedure currently scheduled for after Aug. 19, 2021, Springfield Clinic ASC staff will be contacting you to discuss your surgery options. 

Effective Nov. 17, 2021, BCBS will be out-of-network for primary, specialty and urgent care and all additional medical services and lab services at all Springfield Clinic locations.  

We urge you to review and understand your plan’s benefits and review other options. We regret that this may impact you, and we are attempting to work with Blue Cross Blue Shield to resolve this matter. 

Springfield Clinic will still participate in Blue Cross Community Health Plan, Blue Cross Blue Shield Medicare Medicaid Alignment Initiative (MMAI) HMO and Blue Cross Blue Shield Medicare Advantage plan offered via Physician Health Association of Illinois (PHAI).

I am currently in the middle of care and treatment. Can I continue to see this doctor?

BCBS has a continuity of care policy that may apply. You will need to contact BCBS at the phone number on the back of your member card to see if you will qualify for this temporary coverage extension. We will do everything we can to support you, if you need this coverage. 

If I choose to remain with BCBS, what other in-network providers can I see for care?

You can contact Blue Cross Blue Shield to understand what your options are for in-network care. We will do everything we can to support your transition to an in-network provider, if you choose to do so. 

If I want to keep seeing my Springfield Clinic providers, how much should I expect to spend in out-of-pocket costs?

You should contact BCBS to review your plan benefits for out-of-network care and any related cost-sharing amounts. 

Why are other PPOs accepted but not this one?

Springfield Clinic maintains relationships with many insurance companies in order to provide services at an exceptional value to you. Each relationship is individual and does not affect other insurance options available to you. You can view the current list of in-network insurance options on our website, www.springfieldclinic.com/insurance.

Is there any chance of resolution with BCBS?

We are attempting to work with BCBS to resolve this, but we do not know at this time. We have a fully staffed call center at 217.391.7086 ready to take your questions and concerns. 

Who can I lodge a complaint with?

You can reach out to BCBS: 

  • By calling BCBS at the phone number on the back of your member card
  • By writing:  

Blue Cross and Blue Shield of Illinois 
300 East Randolph Street 
Chicago, IL 60601-5099 

You can also contact the Illinois Department of Insurance Office of Consumer Health Insurance at insurance.illinois.gov/main/contactUs.html or by phone 217.782.4515.

Why did I receive a patient letter?

You are in our records as having Blue Cross Blue Shield commercial PPO insurance, based on the last time you updated your insurance with us. We pulled insurance records for active patients starting Jan. 1, 2019 through the present. A copy of the letter mailed to patients is posted on this page below. If you would like to update your insurance or patient information with us, please call the Springfield Clinic insurance call center at 217.391.7086. 

Frequently Asked Questions Regarding the Blue Cross Blue Shield Choice Plan

Can I still see my Springfield Clinic doctor if I choose the Blue Cross Blue Shield Choice plan?

Yes, but you should review the benefits and what the out-of-network costs will be for you under the Blue Cross Blue Shield Choice plan. 

What are my options for in-network providers with Springfield Clinic if I'm on the Blue Cross Blue Shield Choice Plan?

Springfield Clinic is continuing our contracts with multiple insurance companies, including:

  • AETNA
  • Consociate Care
  • Current Health
  • Health Alliance
  • HealthLink
  • HFN
  • HOPE Trust
  • Humana
  • Live 360
  • Multiplan/PHCS
  • UnitedHealthcare

You should contact your Human Resources department to discuss your options. If you purchased your health care insurance through the governtment exhange (HealthCare.gov), then you have the option of switching plans through Aug. 15, 2021.

What insurance plans will Springfield Clinic be accepting for State of Illinois employees effective July 1, 2021?

All plans offered by the State of Illinois are in-network except the Blue Cross Blue Shield (BCBS) plans. 

Springfield Clinic is committed to providing you with the best care at an exceptional value. The best value for State of Illinois employees for Open Enrollment 2021-2022 are the following in-network plans:

  • AETNA: HMO & OAP 
  • AETNA: Consumer Driver Health Plan (CDHP) 
  • AETNA: Quality Care Health Plan (QCHP) 
  • Health Alliance Medical Plans: HMO 
  • HealthLink: OAP 

Contact a Managed Care representative at 217.528.7541 ext. 43565 for further questions.

 

Blue Cross Blue Shield indicates that the Choice contract ends on November 17 and Springfield Clinic says July 1. Are services provided at Springfield Clinic in-network or out-of-network from July 1 through November 17, 2021?

Our notice indicates that Springfield Clinic is out-of-network for BCBS Choice members on July 1. BCBS, however, ultimately decides whether to process a claim at the in-network or out-of-network rate.  We would recommend that you contact BCBS to determine which network rate will apply to your visit/procedure/service.


This letter is for patients with an existing Blue Cross Blue Shield PPO insurance plan. Click the image to enlarge.

open link to Termination Patient Letter pdf