{"604614":{"#nid":"604614","#data":{"type":"news","title":"Negotiations Continue with Piedmont, Blue Cross Blue Shield of Georgia","body":[{"value":"\u003Cp\u003EAs of April 1, Piedmont Healthcare doctors and hospitals became out-of-network providers for employees enrolled in a Blue Cross Blue Shield of Georgia (BCBSGa) health care plan.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Ca href=\u0022http:\/\/ohr.gatech.edu\u0022\u003EGeorgia Tech Human Resources\u003C\/a\u003E will continue to monitor the negotiations and communicate as additional information becomes available.\u0026nbsp;For now, read on for what you need to know if you or your family members are enrolled in a BCBSGa plan.\u003C\/p\u003E\r\n\r\n\u003Cp\u003ESince negotiations have thus far been unsuccessful, continuing to use Piedmont doctors and facilities will be considered out-of-network unless you are approved through a Continuation of Care request. Employees or their dependents who are subscribed to a BCBSGa plan and already being treated for a specific medical condition may apply to receive in-network-level benefits for a limited time.\u0026nbsp;\u003Cstrong\u003E\u003Ca href=\u0022http:\/\/edit.hg.gatech.edu\/sites\/default\/files\/attachments\/BCBSGa_COC_Request_Form.pdf\u0022\u003EHere is a form\u003C\/a\u003E\u003C\/strong\u003E with additional information about Continuation of Care and how to apply. Without Continuation of Care, out-of-network rates will apply.\u003C\/p\u003E\r\n\r\n\u003Ch4\u003E\u003Cstrong\u003EFor Consumer Choice HSA and Comprehensive Care Members\u003C\/strong\u003E\u003C\/h4\u003E\r\n\r\n\u003Cp\u003EOut-of-network care will be covered at 60 percent of the negotiated rate, subject to any deductibles.\u0026nbsp;\u003Cstrong\u003EIn this case, you will be\u003C\/strong\u003E\u0026nbsp;\u003Cstrong\u003Esubject to balance billing\u003C\/strong\u003E.\u0026nbsp;Balance billing is the process where the provider bills the patient for the remaining portion of the full charge that BCBSGa did not pay.\u003C\/p\u003E\r\n\r\n\u003Cp\u003E\u003Cstrong\u003EExample\u003C\/strong\u003E: Out-of-network Piedmont ER visit\u003Cbr \/\u003E\r\nFull Rate = $1,200*\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003Cbr \/\u003E\r\nBCBSGa negotiated rate = $500*\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003C\/p\u003E\r\n\r\n\u003Cul\u003E\r\n\t\u003Cli\u003EBCBSGa will pay 60 percent of the BCBSGa negotiated rate, or $300\u003C\/li\u003E\r\n\t\u003Cli\u003EPiedmont will then balance bill the patient $900 as the remaining amount of the Full Rate\u003C\/li\u003E\r\n\u003C\/ul\u003E\r\n\r\n\u003Cp\u003E\u003Cem\u003E*Not actual amounts; used for example purposes only. These amounts could be higher or lower than shown.\u003C\/em\u003E\u003C\/p\u003E\r\n\r\n\u003Ch4\u003E\u003Cstrong\u003EFor BlueChoice HMO Members\u003C\/strong\u003E\u003C\/h4\u003E\r\n\r\n\u003Cp\u003EOut-of-network care is not covered under the BCBSGa HMO plan. Employees enrolled in the BCBSGa HMO plan would be responsible for the full cost of care.\u003C\/p\u003E\r\n\r\n\u003Cp\u003ETo determine if any of your physicians or providers are affiliated with Piedmont Healthcare, use the\u0026nbsp;\u003Ca href=\u0022https:\/\/doctors.piedmont.org\/\u0022\u003EPiedmont Healthcare Physician search tool\u003C\/a\u003E. To avoid incurring the higher costs of using an out-of-network doctor, use the\u0026nbsp;\u003Ca href=\u0022https:\/\/www13.bcbsga.com\/cp\/web\/usg\/find-a-doctor\u0022\u003E\u0026ldquo;Find a Doctor\u0026rdquo; tool\u003C\/a\u003E\u0026nbsp;on the\u0026nbsp;\u003Ca href=\u0022http:\/\/www.bcbsga.com\/USG\u0022\u003EBCBSGa microsite\u003C\/a\u003E to find in-network physicians. You will be able to find a listing of in-network BCBSGa doctors and facilities in your area by sorting the type of doctor or specialty. You also will want to confirm that the doctor you choose is not represented in the\u0026nbsp;\u003Ca href=\u0022https:\/\/doctors.piedmont.org\/\u0022\u003EPiedmont Healthcare Physician search tool\u003C\/a\u003E.\u003C\/p\u003E\r\n","summary":null,"format":"limited_html"}],"field_subtitle":"","field_summary":[{"value":"\u003Cp\u003EAs of April 1, Piedmont Healthcare doctors and hospitals became out-of-network providers for employees enrolled in a Blue Cross Blue Shield of Georgia (BCBSGa) health care plan.\u003C\/p\u003E\r\n","format":"limited_html"}],"field_summary_sentence":[{"value":"As of April 1, Piedmont Healthcare doctors and hospitals became out-of-network providers for employees enrolled in a Blue Cross Blue Shield of Georgia (BCBSGa) health care plan."}],"uid":"27469","created_gmt":"2018-04-03 13:21:52","changed_gmt":"2018-04-03 14:17:38","author":"Kristen Bailey","boilerplate_text":"","field_publication":"","field_article_url":"","dateline":{"date":"2018-04-03T00:00:00-04:00","iso_date":"2018-04-03T00:00:00-04:00","tz":"America\/New_York"},"extras":[],"hg_media":{"581774":{"id":"581774","type":"image","title":"Health Care Graphic","body":null,"created":"1475003547","gmt_created":"2016-09-27 19:12:27","changed":"1522761873","gmt_changed":"2018-04-03 13:24:33","alt":"clipboard graphic","file":{"fid":"227465","name":"healthcare.jpg","image_path":"\/sites\/default\/files\/images\/healthcare_0.jpg","image_full_path":"http:\/\/tlwarc.hg.gatech.edu\/\/sites\/default\/files\/images\/healthcare_0.jpg","mime":"image\/jpeg","size":37888,"path_740":"http:\/\/tlwarc.hg.gatech.edu\/sites\/default\/files\/styles\/740xx_scale\/public\/images\/healthcare_0.jpg?itok=-qtJRqP0"}}},"media_ids":["581774"],"related_links":[{"url":"http:\/\/www.bcbsga.com\/blog\/member-news\/piedmont-provider-network-update\/","title":"FAQ from BCBSGa"},{"url":"http:\/\/keeppiedmont.org\/frequently-asked-questions\/","title":"FAQ from Piedmont"},{"url":"http:\/\/edit.hg.gatech.edu\/sites\/default\/files\/attachments\/BCBSGa_COC_Request_Form.pdf","title":"Continuation of Care Request Form (pdf)"}],"groups":[{"id":"1214","name":"News Room"},{"id":"64303","name":"Human Resources"}],"categories":[{"id":"129","name":"Institute and Campus"}],"keywords":[{"id":"2493","name":"health care"},{"id":"4288","name":"benefits"},{"id":"1966","name":"usg"},{"id":"726","name":"University System of Georgia"},{"id":"2775","name":"human resources"},{"id":"3423","name":"employees"}],"core_research_areas":[],"news_room_topics":[{"id":"71871","name":"Campus and Community"}],"event_categories":[],"invited_audience":[],"affiliations":[],"classification":[],"areas_of_expertise":[],"news_and_recent_appearances":[],"phone":[],"contact":[{"value":"\u003Cp\u003EIf you have questions, contact \u003Cstrong\u003E\u003Ca href=\u0022mailto:benefits@ohr.gatech.edu?subject=BCBSGa%20Inquiry\u0022\u003Ebenefits@ohr.gatech.edu\u003C\/a\u003E\u003C\/strong\u003E.\u003C\/p\u003E\r\n","format":"limited_html"}],"email":[],"slides":[],"orientation":[],"userdata":""}}}