Libertyville hospital trying to sever ties with Blue Cross
Attorneys for Blue Cross Blue Shield of Illinois asked a Cook County Circuit Court judge Tuesday for an emergency temporary restraining order to keep Condell Medical Center from prematurely terminating its contract.
The Libertyville-based hospital announced last week it will bill Blue Cross patients directly, instead of filing claims with the insurance company. That means patients would be responsible their entire bill and would have to be reimbursed by Blue Cross.
Condell officials say they had to terminate the contract because Blue Cross has been withholding funds since June for services rendered.
Blue Cross Blue Shield officials said the company stopped making advance payments to Condell for patient services rendered because the hospital was asking for a higher rate of reimbursement.
The dispute affects Blue Cross PPO patients, estimated to be tens of thousands in Lake County, and about 11,000 Blue Cross HMO patients.
Blue Cross Blue Shield attorneys argued Tuesday that there has been "no material breach" of the contract, and that patients will feel the negative effects of negotiations gone awry.
"In February 2007, Condell's new vice president, Jodi Levine, told Blue Cross that Condell needed a 37 percent increase in the current fee. Levine also informed Blue Cross that Condell wanted the increase in fees to be made retroactive to January 1, 2007," court documents said.
Court documents also allege Condell told Blue Cross Blue Shield it was in "survival mode," and without the 37 percent increase, Blue Cross would "drive Condell out of business."
Levine rejected any implication that Condell was facing bankruptcy.
"What we stated in our written documentation is that because we lose money on every Blue Cross patient, and Blue Cross market share is growing, that eventually that will put us in a very, very challenging situation," Levine said in a telephone interview. "I know of no business in any industry that can thrive when its largest customer doesn't pay enough to cover its costs," she added.
A court decision is expected shortly.