Member message (to be distributed to employers and producers by mass e-mail)

To our members in the Lubbock area

from Blue Cross and Blue Shield of Texas

As you may already know, one physician group in the Lubbock area, Covenant Medical Group (CMG), has given Blue Cross and Blue Shield of Texas* notice that they will end their PPO and HMO agreements with us beginning in mid-September, unless we agree to reimburse them at higher levels than other local physicians practicing the same specialties.

The Blue Cross and Blue Shield of Texas philosophy is that we should pay providers in the same specialty, in the same geographic area, who offer the same services, the same reimbursement. As the only statewide non-investor owned health insurer, Blue Cross and Blue Shield of Texas is committed to providing you with access to quality, affordable health care benefits while providing fair and equitable reimbursements for the physicians who participate in our networks.Our approach to keeping that commitment is to invite all physician groups in Lubbock to participate in our networks at reimbursement levels comparable to other physicians practicing the same specialties in Lubbock and surrounding counties.

What does CMG’s decision mean to you?

This CMG decision will not affect your access to more than 450 other physicians in our Blue Choice®network in the Lubbock area, of which more than 96% of the physicians are accepting new patients.During this transition, many in-network providers have called our local office to indicate they are available to accept new patients.In addition, we continually recruit new providers who are locating in Lubbock.

Regardless of this group’s decisions, we will continue to offer our members solid health care options:

  • You will still have access through Blue Cross and Blue Shield of Texas to the largest physician and health care provider network in Texas.
  • Members may still choose out-of-network providers although out-of-pocket costs may be higher.
  • You may choose a new primary care physician who participates in your network by calling the customer service number listed on the back of your ID card or visit Provider Finder® at bcbstx.com, which is updated daily, to view a directory of providers in all our networks.
  • If you are involved in a specific medical treatment, transitional care benefits can be requested through a customer service representative at the phone number listed on the back of your ID card.

If you have any questions, call the number on the back of your ID card to speak with a customer service advocate, who will be happy to provide complete information about options for obtaining care.

* A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.