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Springfield Clinic Network Status

Our members are at the core of everything we do. Blue Cross and Blue Shield of Illinois (BCBSIL) is committed to working with health care providers across the state to advance access to quality, value-based health care.

Our focus is on value for our members and employer groups — and that means facilitating access to quality care at a competitive price.

Springfield Clinic first sent us an improper 30-day termination notice for one of our networks, Blue Choice. The timing of that termination notice coincided with the 2021 open enrollment period for one of the largest employers in Springfield. Near that time, Springfield Clinic also sent misleading communications directly to BCBSIL members and to the marketplace, creating concern and confusion.

We’d like to share the facts:

  • Springfield Clinic’s participation agreement for the PPO and Blue Choice networks will terminate on November 17, 2021, unless a new arrangement can be made.  
  • Springfield Clinic remains in-network for BCBSIL PPO, Blue Choice Options, Blue Choice Select, Blue Choice Preferred members until November 17, 2021.
  • Springfield Clinic remains in-network for the BCBSIL Blue Choice Tier 1 benefits for the State of Illinois Open Access Plan members until November 17, 2021.
  • In addition, Springfield Clinic’s ambulatory surgery center agreement for participation in all commercial networks, including PPO, Blue Choice and HMO networks, will terminate on August 19, 2021.

We will use the time between now and November 17 to best support our members. This window of time will allow BCBSIL to inform members and groups of their options. It also will give BCBSIL and Springfield Clinic the opportunity and time to work toward a collaborative resolution that continues access to quality, cost-effective care.

If we are not able to reach an agreement that provides the kind of quality and value our members deserve, we will help our members choose an in-network provider.

This will allow them to continue to take maximum advantage of lower out-of-pocket costs and to continue to build in-network accruals toward their deductible. BCBSIL has network arrangements in place with other providers in the Springfield area who demonstrate a commitment to quality and value. Some members being treated for certain conditions also may be covered by what is known as "continuity of care." This means they may still be able to use Springfield Clinic at the in-network benefit level under their current plan for a period of time, even if Springfield Clinic is out-of-network.

We encourage members to call the number on their member ID card with questions about their BCBSIL coverage, including any continuity of care questions. We’re here to help.

If you have any questions about Springfield Clinic’s engagement and messaging on this topic, please call Springfield Clinic at 217.391.7086.

We continue to be open and hopeful around future successful agreement discussions with Springfield Clinic that focus on quality, value-based, outcome-driven health care to best serve our members.

Your questions

Q: Is Springfield Clinic in-network if I have a Blue Choice or PPO plan?

A: Yes. Springfield Clinic is currently in-network and will remain in-network until November 17, 2021 for the BCBSIL PPO and Blue Choice networks. Blue Choice plans include Blue Choice Options, Blue Choice Select and Blue Choice Preferred. Springfield Clinic also remains in-network for the BCBSIL Blue Choice Tier 1 benefits for the State of Illinois Open Access Plan members until November 17, 2021  After November 17, 2021 Springfield Clinic providers will be out-of-network, unless an agreement can be reached which focuses on quality and value- based care.

Q: Is Springfield Clinic in-network if I have an HMO plan?

A: BCBSIL does not directly contract with Springfield Clinic for HMO plans. Springfield Clinic instead contracts with PHAI for their participation in the networks. Springfield Clinic has sent a notice to PHAI that they will be terminating their contract as of June 30, 2021. However, PHAI will continue to remain in-network and will actively participate in BCBSIL’s Blue Advantage and HMOI plans. 

Q: Is Springfield Clinic in-network if I have a Blue Cross Medicare or Medicaid plan?

A: Yes, Springfield Clinic is in-network for Blue Cross and Blue Shield of Illinois Medicare, Medicaid, and MMAI plans.

Q: Why did Springfield Clinic first say it was going out-of-network for some BCBSIL plans on July 1, 2021?

A: We are unsure. This is incorrect information caused confusion for our members and group customers. Springfield Clinic’s participation agreement for the PPO and Blue Choice networks will terminate on November 17, 2021, consistent with the details of our agreement, unless a new arrangement can be made.  At this time, there is no need for BCBSIL members to take any action. BCBSIL will timely notify members if a new agreement with Springfield Clinic is unable to be reached.

Q: For the State of Illinois Open Access Plan (OAP), what is changing?

A: For now, nothing is changing: BCBSIL Blue Choice Network providers are in Tier 1, PPO is Tier 2 and OON is Tier 3. After November 17, 2021, Springfield Clinic will be out-of-network for all Open Access Plan options, unless an agreement can be reached which focuses on value and quality.

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About Blue Cross and Blue Shield of Illinois
Blue Cross and Blue Shield of Illinois (BCBSIL) is committed to expanding access to quality, cost-effective health care to as many people as possible in Illinois. BCBSIL is dedicated to innovation and exploring, nurturing and activating future possibilities to make the health care system work better for our members and our communities. BCBSIL is a division of Health Care Service Corporation, a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.



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