Important information for patients with health insurance through Blue Cross and Blue Shield.

Baylor Scott & White Health (BSWH) is currently negotiating a new contract to cover care for patients with Blue Cross and Blue Shield of Texas (BCBSTX) health insurance. Patients who have coverage from an out-of-state Blue Cross and Blue Shield plan may also be impacted.

We are working to reach an agreement by July 1, 2024, so plan holders may continue to receive in-network coverage for care with our providers and facilities, including those that do not operate with the Baylor Scott & White Health name. You are our top priority, and we are working to minimize any potential disruptions.

Right now, nothing is changing. You can still see your care team at BSWH as we continue negotiating in good faith to preserve your in-network access.

If you wish to request continued access, a Continuity of Care form can be found on BCBSTX’s website. Check the second box and look for your BSWH provider’s contact information here. (Note: The form asks for an “NPI ID #.” This is a National Provider Identifier consisting of a unique 10-digit number for your provider. You can find the number by searching the national provider database.)

The Continuity of Care form may be faxed or mailed to BCBSTX for consideration. Because BCBSTX approves and denies requests, BSW cannot provide status updates. If you obtain approval for Continuity of Care from BCBSTX, please share the letter with your provider.

Frequently asked questions

  • What is happening?

    Baylor Scott & White Health (BSWH) is currently negotiating a new contract to cover care for patients with Blue Cross and Blue Shield health insurance. This includes Blue Cross and Blue Shield of Texas (BCBSTX) as well as Blue Cross and Blue Shield plans from other states. We are working to reach an agreement by July 1, 2024, to keep BCBSTX plan holders in-network for care with our providers and facilities.  Our patients are our top priority, and we are working to minimize any potential disruptions.

  • How does this impact Baylor Scott & White patients?

    Right now, nothing is changing. Patients should continue to visit Baylor Scott & White hospitals, facilities, and providers as they normally would through the month of June. If an agreement is not reached by July 1, 2024, Blue Cross and Blue Shield of Texas (BCBSTX) will be considered out of network for care delivered by Baylor Scott & White Health (BSWH) doctors and facilities for most BCSBTX members. This could mean increased costs for BCBSTX patients who want to continue receiving care from a Baylor Scott & White Health facility or provider.

  • What if I have an appointment with my Baylor Scott & White provider scheduled on or after the date the agreement ends?

    At this time, we are advising patients to keep the appointments they have scheduled on or after July 1, 2024. Canceling services could delay care and it may not be necessary if an agreement is reached before the current contract expires. In addition, some patients may be eligible for Continuity of Care through BCBSTX. (A link to BCBSTX’s Continuity of Care form can be found at the top of this webpage.)

    If an agreement is not reached before the last week of June, BSW will begin reaching out to patients who have appointments scheduled in July. If you are unable to obtain a Continuity of Care exception through BCBSTX, services provided after July 1, 2024 will be considered out of network, and your BCBSTX benefits may not cover your care. If that happens, first ask BCBSTX if you have out-of-network coverage.

    In the event an agreement is not reached before July 1, 2024, and a continuity of care form is not obtained, BSW will give patients the option to reschedule to a later date or sign an out of network form to accept responsibility for 75% of the charges that would have otherwise been billed to BCBSTX. Your provider can give you specifics based on the services delivered.

  • What if I am receiving treatment for a special condition on or after the date the agreement ends?

    If an agreement is not reached by July 1, 2024, some services may still be covered for a short period of time if they already began and are not yet complete; however, we encourage patients to talk with their medical team if they have clinical questions about their care. Certain patients, including those who are hospitalized or undergoing an active course of treatment before the contract end date, may qualify for Continuity of Care through BCBSTX. If you think you may qualify, call the phone number on the back of your BCBSTX health insurance card today to request a Continuity of Care form and apply. You may also find a link to the Continuity of Care form at the top of this webpage.

  • What if I have an elective procedure scheduled at a Baylor Scott & White facility on or after the date the agreement ends?

    If an agreement is not reached by July 1, 2024, you will need to obtain a Continuity of Care exception through BCBSTX; Otherwise, services provided after this date will be considered out of network and your out-of-pocket costs may be greater. (A link to BCBSTX’s Continuity of Care form can be found at the top of this webpage.)

  • What if I have a medical emergency on or after the date the agreement ends, and Baylor Scott & White is out of network?

    If you experience a medical emergency, you should always visit the nearest emergency department. BCBSTX will pay for services you receive to evaluate and stabilize an emergency medical condition, regardless of whether your care is received from an in-network or out-of-network emergency department.

  • What do I do if I need to schedule a new appointment?

    We recommend scheduling as needed in late July or August.

  • Which plans are included in this negotiation?

    BCBSTX Medicare supplement plans are not included in this negotiation. The following plans are included in this negotiation:

    • ParPlan
    • Health Select
    • Blue Choice PPO
    • Blue Essentials
    • Blue Advantage HMO
    • Blue Premier / High Performance Networks (HPN)
    • Blue Cross Medicare Advantage (PPO)
    • Blue Cross Medicare Advantage (HMO)
    • Managed Medicaid STAR Kids
    For Providers
    Epic Code Plan Name
    421520 BLUE CROSS BS HEALTH SELECT OF TEXAS
    421550 BCBS OF TX BLUE PREMIER
    421553 BLUE ESSENTIALS/HMO BLUE TEXAS
    421556 TRANSPLANT BCBS PPO
    421558 BCBS OF TX PPO/POS
    421559 BCBS OUT OF STATE
    421561 LIMITED PYMT INS BLUE CROSS
    421564 MYBLUE HEALTH OON
    421565 BCBS OF TX PPO CITY OF DALLAS
    421566 HIGH PERFORMANCE NETWORK
    421567 BCBS OF TX PPO TEXAS A&M
    421568 CITY OF DALLAS PPO TRANSPLANT
    421569 BCBS FEDERAL
    220501 BCBS TX STAR
    220504 BCBS - STAR KIDS
    220506 BCBSTX MEDICAID
    220507 BCBS CHIP
    404950 BCBS OF TX MCARE ADVANTAGE
    404951 TRANSPLANT BCBS MEDICARE GENERIC
    404952 BCBS MCARE ADVANTAGE 84980
    404954 BCBSTX MEDICARE ADVANTAGE GROUP RETIREE
    132601 BCBS BLUE ADVANTAGE PPO EXCHANGE
    132602 BCBS BLUE ADVANTAGE PPO TRANSPLANT EXCHANGE
    136101 BCBS BLUE ADVANTAGE HMO TRANSPLANT EXCHANGE
    136102 BCBS BLUE ADVANTAGE HMO EXCHANGE
    136103 TRANSPLANT BCBS OOS
    136104 TRANSPLANT BCBS HMO
  • Which facilities are impacted?

    All Baylor Scott & White locations, including hospitals, urgent care, imaging centers, ambulatory surgery centers and free-standing clinics are included in this negotiation.

    The negotiation also includes the following sites affiliated with Baylor Scott & White Health:
    Hospital - Surgical North Central Surgical Center
    Surgery Centers  Bear Creek Surgery Center
    Lone Star Endoscopy
    North Texas Surgery Center
    Park Cities Surgery Center
    Sherman Endoscopy Center
    SurgCenter
    Texas Endoscopy
    Tuscan Surgery Center at Las Colinas
    Free-Standing Imaging Centers Advanced Imaging Center
    Blue Star Imaging at The Star
    Urgent Care Centers NextCare
  • Does this negotiation apply to Blue Cross and Blue Shield plans from other states?

    Yes. BCBSTX negotiates network contracts on behalf of all Blue Cross and Blue Shield plans. Patients with a policy from an out-of-state Blue Cross and Blue Shield plan utilize the BCBSTX network.