Haywood Regional Medical Center Frequently Asked Questions
March 3, 2008
What you should do in a medical emergency: Blue Cross and Blue Shield of North Carolina and the North Carolina State Health Plan always advise members to go to the nearest hospital in an emergency. Members can continue to use Haywood Regional Medical Center for emergency services without prior authorization. |
- What’s going on between Blue Cross and Haywood Regional Medical Center?
- What’s going on between the North Carolina State Health Plan and Haywood Regional Medical Center?
- How long is the withdrawal?
- What about customers who have procedures scheduled at Haywood Regional?
- What if customers have a scheduled procedure that cannot reasonably be moved?
- What about customers currently admitted to the hospital?
- How many customers are affected by the hospital’s network withdrawal?
- What local hospitals participate in your networks?
- What North Carolina State Health Plan members are affected by this decision?
- Will members be able to go to Haywood Regional Medical Center?
- What about members whose plans allow for out-of-network benefits?
- What about emergency care?
What’s going on between Blue Cross and Haywood Regional Medical Center?
The hospital has voluntarily and temporarily withdrawn from the networks of Blue Cross and Blue Shield of North Carolina, including the State Health Plan PPO network, as it addresses issues raised in recent Medicare inspections.
What’s going on between the North Carolina State Health Plan and Haywood Regional Medical Center?
The hospital has voluntarily and temporarily withdrawn from the Indemnity plan network, as it addresses issues raised in recent Medicare inspections.
How long is the withdrawal?
Based on our conversations with the Haywood Regional and our discussions with BCBSNC, we anticipate that Haywood Regional would rejoin our networks once it is again certified by Medicare and the hospital has ensured us that no quality-of-care concerns exist.
What about customers who have procedures scheduled at Haywood Regional?
The hospital’s withdrawal affects all non-emergency procedures scheduled at Haywood Regional starting on March 1, 2008 for PPO members and on March 10, 2008 for Indemnity plan members. Customers with scheduled procedures or services at the hospital should contact their physicians to arrange for services at a participating facility. Services received prior to March 10, 2008, will be treated as in-network.
What if customers have a scheduled procedure that cannot reasonably be moved?
We will be as flexible as we can with customers whose requests for covered services were authorized before March 1, 2008. Given concerns raised by the Medicare program, we would encourage customers to work with their physicians to move their procedures to a participating hospital.
What about customers currently admitted to the hospital?
We do not anticipate requiring patients to move to other facilities for in-network care if they were admitted before March 1, 2008. All admissions prior to March 1, 2008 will be paid at in-network levels regardless of discharge date.
How many customers are affected by the hospital’s network withdrawal?
The State Health Plan has approximately 3,000 customers in Haywood County participating in products that are affected by the hospital’s action.
What local hospitals participate in your networks?
Eight hospitals within about 40 miles of Haywood Regional Medical Center are participating hospitals. Participating hospitals include:
| Hospital | Location |
Distance |
Harris Regional Hospital |
Sylva |
24.1 miles |
Mission Hospitals |
Asheville |
27.0 miles |
Transylvania Community Hospital |
Brevard |
30.9 miles |
Park Ridge Hospital |
Fletcher |
32.9 miles |
Margaret R. Pardee Memorial Hospital |
Hendersonville |
35.4 miles |
Swain County Hospital |
Bryson City |
39.6 miles |
Highlands Cashiers Hospital |
Macon County |
41.6 miles |
Angel Medical Center |
Franklin |
42.4 miles |
St. Luke's Hospital |
Columbus |
57.3 miles |
Spruce Pine Community Hospital |
Spruce Pine |
63.9 miles |
The McDowell Hospital |
Marion |
64.5 miles |
Rutherford Hospital |
Rutherfordton |
67.9 miles |
Charles A. Cannon, Jr. Memorial Hospital |
Linville |
81.0 miles |
Grace Hospital |
Morganton |
85.6 miles |
Murphy Medical Center |
Murphy |
86.4 miles |
What North Carolina State Health Plan members are affected by this decision?
All members of the North Carolina State Health Plan enrolled in the Blue Options PPO plans and in the Indemnity plan are affected. State Health Plan members can find more information on the State Health Plan Web site.
Will members be able to go to Haywood Regional Medical Center?
During the withdrawal period, members’ in-network care for services at Haywood Regional will be limited to emergency care. We are advising members to go to other hospitals for non-emergency care during the withdrawal period.
What about members whose plans allow for out-of-network benefits?
Our plans do allow members to go to out-of-network hospitals for covered services. Given the concerns raised by the Medicare program, we are encouraging members to go to a participating hospital for non-emergency services. Members are responsible for obtaining any required authorizations for non-emergency, out-of-network care. Please note that members typically face significantly higher out-of-pocket costs for out-of-network services. Be sure to check your benefits book or go to the "Health Plan Options" section for more details.
What about emergency care?
We always advise members to go to the nearest hospital in any emergency.
