My Doctor, My dh's Doctor and the kids pediatrician have all left the Health Alliance PPO network. Just got 3 separate letters in the mail. Anyone know what is going on? Dr. Halperin has been our kids ped since birth. This is such a bummer! Wish I knew what was going on!!!!

Prolly has something to do with the insurance. We had a ppo befor and had a great dr and then things changed and he left becauseof the insurance.

Health Alliance has moved to a OSF St Francis based PPO network. The only individuals that this will not effect is CAT Employees. Below is the portion regarding Peoria County: Peoria County OSF HealthCare System, which includes OSF Saint Francis Medical Center , Children’s Hospital of Illinois and all other associated OSF HealthCare providers, joins the Health Alliance provider network. Most fully insured groups will move to the OSF provider network. The Methodist Medical Center-based network will no longer be offered. However, this will not be the case for Caterpillar. The existing network will remain in place for Caterpillar without OSF HealthCare. Proctor Hospital will remain in the network for all plans and groups. On January 1, 2010, the current Medicare PPO network will be replaced with the OSF HealthCare network and the Methodist-based network no longer offered. Proctor Hospital remains in the Medicare network. Not what you wanted to hear I'm sure I'm sorry.

This makes me sick.

[quote]tls1995 writes: Health Alliance has moved to a OSF St Francis based PPO network. The only individuals that this will not effect is CAT Employees. Below is the portion regarding Peoria County: Peoria County OSF HealthCare System, which includes OSF Saint Francis Medical Center , Children’s Hospital of Illinois and all other associated OSF HealthCare providers, joins the Health Alliance provider network. Most fully insured groups will move to the OSF provider network. The Methodist Medical Center-based network will no longer be offered. However, this will not be the case for Caterpillar. The existing network will remain in place for Caterpillar without OSF HealthCare. Proctor Hospital will remain in the network for all plans and groups. On January 1, 2010, the current Medicare PPO network will be replaced with the OSF HealthCare network and the Methodist-based network no longer offered. Proctor Hospital remains in the Medicare network. Not what you wanted to hear I'm sure I'm sorry. [/quote] Do you know why this decision was made, tls? Did Methodist not pass some sort of JCAHO review or Medicare standards? Or did OSF and Proctor under bid Methodist in some way? Or what? This can't be good news for Methodist and it sickens me to think of OSF becoming the healthcare equivelent of Wal-Mart, running competition out of business.

I'm going to make some phone calls.... we have always gotten our health care at Methodist. Their medical professionals are outstanding and some are like family. I'll report back

As of Jan 1 this year my doctor's group no longer goes to Proctor Hospital and I use to go there all the time as the care there was great, at least for me and it is close for me. The ER you usually did not have long waits. I had both hip replacements done there and there PT dept was awesome. Now I have to go to the " mother" hospital.

OSF is way too large for my taste. It would be too easy for something to "fall between the cracks". Methodist was perfect. Not too big- not too small.

I don't know why Health Alliance decided to change. I'm sure they see it as a good move as the only fully insured PPO networks that included OSF are currently Blue Cross and Humana. For people who insist on having OSF that really narrowed their chooses of available health plans. Personally I don't like OSF Hospital at all. My brohter was there before he died and your right JNJ youcan so easily fall through the cracks over there. As for the Methodist doctors no longer going over to Proctor (my hospital of choice also Msgem) this was a decision made by Methodist. I've had seeral conversations with my Methodist doctor and my pediatrician (also a Methodist owned doctor) and what it comes down to is Methodist told the physicians they "own" that they could no longer go out to Proctor. It's their way of stearing business to their own hospital the way I see it. JNJ if you have a PPO plan you can still go to the Methodist physicians your claims will just be processed at the Out-of-Network benefit. You do have to be careful of doing this as there could be other penalties involved also. You really need to read your current policy carefully.

I received the same letter for hamp. I was quite happy with my MMG doc and Methodist care. I have applied for insurance with the Blues. My doc is in the Blue plan and Methodist will match rates with OSF in addition to waiving my deductible. Not a bad deal.

Oldie becareful of using the Methodist Matching program. As of my last conversation with them yesterday they will waive the Out-of-Network penalties BCBS applies but they have not decided yet if they will waive the amount that BCBS considers "over reasonable and customary". Also they don't waive the entire deductible just the additional portion you will be chareged by your carrier for going out-of-network. If you can get them to waive these two things, for your own sake, get it in writing from the! That being said, BCBS is the very best plan out there. However you do pay for waht you get. Their rates are higher than others but their service and quality is are also superior.

Hey everyone I just received clarification on the Methodist Medical Center Matching Program Oldie mentioned above. They are now accepting whatever BCSB sends them as payment in full if you have one of the PPO plans. Remember though this is for hospital billed services only. It does not apply to physician services including but no limited to Pathologist charges, Radiology charges, and Emergency Physicians charges. You have to remember that the physician is not an employee of the hospital even if they work there so they bill seperatly.