Blue Cross reinstates most Condell doctors

Blue Cross Blue Shield of Illinois has reinstated most of the 93 doctors affiliated with Condell Medical Center who were dropped from the insurance giant's PPO network last week.

The physicians were shut out because they had admitting privileges solely at the Libertyville hospital, which is no longer part of Blue Cross' network.

Condell ended its PPO contract with Blue Cross this month because the insurer stopped making advance payments for patient services in June. The move affects tens of thousands of Blue Cross PPO and HMO patients in Lake County, who would have to find new doctors.

"So far, 80 physicians have been reinstated into Blue Cross' PPO network," said company spokesman Tony Rau. "Many primary care physicians have been reinstated after providing verification that they have obtained or are in the process of obtaining admitting privileges at alternate hospitals."

Blue Cross also reinstated all hospital-based physicians providing emergency room care at Condell, including emergency medicine, anesthesiology, pathology and radiology, Rau said.

"We currently are reaching out to the remaining physicians to discuss their options," Rau said.

Many physicians say the damage has been done.

"It's incredibly disruptive," said Dr. Charles Colodny of Libertyville. "I have patients who are frantic. The patients don't believe Blue Cross, and what they are doing is going to find doctors on other hospital staffs."

Blue Cross' latest decision comes a week after a group of Condell physicians publicly criticized the insurance giant for shutting them out of its network.

"Sounds like Blue Cross is backing off," said Dr. James Milam, a Vernon Hills obstetrician/gynecologist and chief of staff for Condell's in-hospital physicians and private doctors. "It's certainly good news for the patients in the short term because they can still maintain their relationship with the doctors that they have come to know and trust."

Condell officials don't know what to make of this latest move by Blue Cross.

"We have received no direct communication from Blue Cross at all to indicate that new steps are being taken," said Andy Stefo, Condell's chief financial officer. "We're very encouraged if they're taking steps to preserve that (PPO) network in Lake County so that patients aren't forced to change physicians."

Blue Cross 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.

"We are relieved there's been a reprieve for now," said William Maloney, Condell's emergency department medical director. "The fact that things have been changing back and forth, it's hard enough for just the physicians in the hospital to keep it straight, let alone the patients."