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Broker News | February 26, 2015
Broker News | February 26, 2015

Greater Rochester Region Imaging Group Terminating from Network

Effective April 1, 2015, Borg and Ide Imaging Group P.C. ("Borg and Ide"), a provider of radiology imaging services (e.g., x-rays, MRIs, ultrasounds), will no longer be part of our participating provider network for our Commercial and Medicare Advantage lines of business. Please know that we have negotiated with Borg and Ide in good faith to avoid any disruption to our members, however as your locally based nonprofit health plan, we feel it is imperative to keep care affordable so that as many people as possible can have access to needed medical services.

We are notifying our members who obtained services from Borg and Ide over the past year and Rochester Region participating providers in an effort to minimize any disruption in treatment and potential for out-of-pocket costs to our members. Depending on the member's contract, they may not have coverage when seeking care from an out-of-network provider:

PPO members: Excellus BCBS PPO members have provisions in their benefit plan allowing them to seek care from out-of-network providers at an increased out-of-pocket cost. They can determine their additional cost sharing responsibilities, should they receive services from Borg and Ide on or after April 1, 2015, by logging into their account on our website, ExcellusBCBS.com

HMO and EPO members: Excellus BCBS HMO or EPO members do not have provisions in their benefit plan allowing them to seek care from out-of-network providers (except for emergency room care). This means that if they receive services from Borg & Ide on or after April 1, 2015, there will be no coverage under their policy, and they will therefore be responsible for 100 percent of the cost for services.

We have many other radiologists and imaging providers who continue to remain in our provider network. Members are encouraged to visit ExcellusBCBS.com/FindProvider and select Find a Doctor or Hospital to find a provider near them. Additionally, if they have any questions about this matter, or would like to speak with a Customer Care Advocate, they may call the number listed on the back of their ID cards.

If you have any questions, please contact your account consultant. Please share with your groups.

Below are examples of the member and provider communications we will be sending out.

View the member communication >> (PDF)

View the provider communication >> (PDF)

 

 

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