/Mike Chaney writes letter on behalf of man in need of liver transplant

Mike Chaney writes letter on behalf of man in need of liver transplant

Dungan is currently ineligible to receive a transplant at UMMC as a candidate for liver transplant with Blue Cross insurance. This is due to the hospital’s status as an out-of-network facility with the insurance company. After a contract dispute between Blue Cross and UMMC, the hospital was placed out of network. Blue Cross is trying to steer Dungan towards out-of-state centers in Memphis and Birmingham. But Dungan still wants to remain with UMMC because he has developed relationships with doctors who are familiar with his past. READ MORE: “I’m afraid I’m going freaking to die”: A Mississippi man cannot get answers from Blue Cross and UMMC. Dungan tried to obtain cost estimates from both UMMC, Blue Cross about what each party would charge and how much he would pay if he had his transplant at the hospital that was not yet in network with the insurer. Dungan couldn’t get any answers so he began calling everyone he could, including the Mississippi Insurance Department. Chaney informed UMMC/Blue Cross that he believes Dungan’s request to be reimbursed is reasonable. “He just asks that UMMC give a good faith estimate for his liver transplant, including an estimate of any increased costs due to balance billing services that may have been rendered after June 30,,” Chaney wrote in a May 13th letter. “Further, he asks that BCBSMS takes the estimated charges provided by UMMC and provides a good faith estimate for the ‘in network rate’ reimbursement that would by BCBSMS… This information is necessary to determine if he has enough savings and assets to pay any additional charges. Chaney also requested that both parties work together to ensure that he can get a transplant without having to travel long distances or become financially insecure. Chaney wrote that they would work together to create a single case agreement that will protect Mr. Dungan against any additional charges beyond his cost-sharing responsibilities. “This single-case approach will allow Mr.. Dungan to receive life-saving transplant without depleting life savings and without having to travel long distances to get it done. If insurance is involved, the hospital will provide an updated cost estimate. Dungan would then direct Blue Cross to pay his “network benefit” amount to him. The balance between Blue Cross’s charges and what UMMC paid would be paid by Dungan. Chaney also made a pointed statement at the conclusion of the letter. He requested that the lawyers review state law that required health insurance companies to maintain a network that was “sufficient” and that all participating providers are available without unreasonable delay. This is not the first time Chaney raised concerns about whether Blue Cross meets network adequacy requirements for UMMC outside of network. In a March 3 letter addressed to Carol Pigott (Blue Cross’ president/chief executive officer), Chaney referred specifically to the “unique” services that are only available at UMMC. Chaney cited, among others, the children’s hospital and organ and tissue transplant program, and the Level IV neonatal intensive medical unit. The letter was sent to the governor, lieutenant governor, and speaker of the House of Representatives. It stated that “without the adequate availability of these specialist services in the BCBSMS Network,”. Chaney ordered Blue Cross to prepare a “Network Adequacy Status Report” that would show how Blue Cross will comply with its statutory requirements if UMMC is removed from the network. When Mississippi Today requested a copy of the Blue Cross response, Cayla Mangrum (manager of corporate communications) said that the report was confidential and proprietary.