In a statement released Wednesday, April 24 by Blue Cross Blue Shield (BCBS), the largest health insurance provider in Texas stated that as of April 15, the emergency room (ER) doctors at many Texas Health Resources (THR) facilities are no longer in-network providers.
THR hospitals remain as in-network facilities; however, many of the ER doctors are employed by a third-party company – in this instance Texas Medicine Resources. BCBS failed to reach an agreement with Texas
Medicine Resources, which resulted in the ER doctors employed by that organization to now be out-of-network providers. The hospitals themselves (see full list below) will still be in the Blue Cross Blue Shield network, but their ERs will not.
According to the statement from BCBS, "Since these outside companies are not in our network, there are no limits to what their providers charge, potentially resulting in significantly higher out-of-pocket costs."
The ERs that are now considered as out-of-network providers are located at the following hospitals:
Click here for a map of the ERs
- Texas Health Arlington Memorial Hospital
- Texas Health Harris Methodist Hospital Alliance
- Texas Health Harris Methodist Hospital Azle
- Texas Health Harris Methodist Hospital Cleburne
- Texas Health Harris Methodist Hospital Fort Worth
- Texas Health Harris Methodist Hospital Hurst-Euless-Bedford
- Texas Health Harris Methodist Hospital Southwest Fort Worth
- Texas Health Harris Methodist Hospital Stephenville
- Texas Health Presbyterian Hospital Allen
- Texas Health Presbyterian Hospital Dallas
- Texas Health Presbyterian Hospital Denton
- Texas Health Presbyterian Hospital Kaufman
- Texas Health Presbyterian Hospital Plano
- Texas Health Presbyterian Hospital Rockwall
that are no longer in-network.
According to Shawn-Marie Riley, CTC Benefits Administrator, if a BCBS member does end up at one of the THR ER that uses out-of-network physicians, the plan will apply in-network benefits, but they could be balanced billed if the provider chooses to not accept our rate as payment in full. Alternative ER options (where the ER physicians remain in-network) include:
- Baylor Scott & White Health
- John Peter Smith Hospital
- Medical City Arlington
- Medical City Dallas
- Medical City Fort Worth
- Methodist Health System
- Methodist Mansfield
- Parkland Health & Hospital System
- USMD Hospital Arlington
- USMD Hospital Fort Worth
- UT Southwestern Medical Center