Blue Cross holders pay more at Thomas

FAIRHOPE, Ala. - Some Blue Cross and Blue Shield of Alabama insurance policy holders have had to pay double their deductible for care at Thomas Hospital. This is all because of the rating system used by insurance companies.

The North Tower is equipped with state of the art equipment, but that's not exactly what the tier system is based on.

The three categories used to rate a hospital are: fiscal, quality, and patient safety. The scale is based out of 100 points, but each category is not weighed equally.

The fiscal category counts for 25 points, and can only be fulfilled if the hospital signs a contract issued by Blue Cross and Blue Shield. If the hospital does not sign that specific contract, it is automatically a tier two hospital.

"We're only rated one star that because we didn't sign their preferred out patient facility agreement. It's just, it's not fair," said Philip Cusa, Administrator at Thomas Hospital.

With a tier two rating, the insurance company pays the health care provider less money. That increased cost to the health care provider is passed down to the patient.

"It's bad information for the public also. They are looking at it, the perception is, 'Oh, Thomas Hospital is not a quality hospital.' They are masking this quality risk thing, safety thing, with fiscal responsibility," said Cusa.

Cusa also said the hospital administration has a good relationship with Blue Cross and Blue Shield, and they hope to work out a better plan that will lower cost. If you have any questions about these deductibles, email Blue Cross and Blue Shield.

The increase in cost will only affect certain policy holders, and these customers should have received notification in the mail.

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