Condell doctors make plea to Blue Cross

A group of private doctors with ties to Condell Medical Center in Libertyville publicly criticized Blue Cross Blue Shield of Illinois Tuesday for shutting them out of its physicians' network.

Blue Cross sent notices last week to roughly 93 doctors with admitting privileges solely at Condell, advising them the hospital is no longer part of its network.

The move affects tens of thousands of Blue Cross PPO and HMO patients in Lake County who will have to find new doctors. PPO members will be reimbursed at "in-network" rates for services received at Condell through Oct. 31. For HMO patients, that coverage is extended through the end of the year.

"Blue Cross is asking physicians to agree to not admit any PPO patients to Condell Medical Center, regardless of medical need or patient preference," said Dr. James Milam, president of the independent medical staff serving Condell.

At Tuesday's press conference, several physicians made an emotional plea to Blue Cross to reconsider.

"It is not fair for patients to be used as pawns in this battle," said Dr. Charles Colodny, a Libertyville family practitioner for 27 years.

Condell and Blue Cross parted ways after a Cook County court ruling last week upheld the hospital's decision to end its contract with the insurance provider.

Condell blamed Blue Cross for breaching the deal by stopping advance cash payments for patient services, worth roughly $20 million. Blue Cross said it did so because Condell was asking for a higher rate of reimbursement than agreed on in the contract.

The 93 doctors have until Nov. 2 to get admitting privileges at other Blue Cross network hospitals.

Several physicians have contacted Blue Cross and are seeking admitting privileges at other area hospitals, said company spokesman Tony Rau.

"We are continuing to reach out to these physicians, and we encourage them to contact us directly to discuss their options," Rau said.

Rau said Blue Cross will provide full benefit coverage to members receiving treatment at Condell under special circumstances, such as patients receiving in-patient care, maternity admissions, cancer treatment, and emergency room services.

Condell's Vice President Jodi Levine said patients and employers in Lake County who are insured through Blue Cross should consider switching providers if they don't want to give up their current Condell doctors.

"There is an opportunity right now for many employers to choose," she said. "I think they need to listen to their employees."