Local pediatricians are feeling the impact of the UMMC legal battle against Blue Cross Blue Shield

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JACKSON, Miss. (WLBT) – Mediation between UMMC and Blue Cross Blue Shield continues for another month as parents of sick children are stuck trying to find new ways to get them treated.

Thousands of Blue Cross Blue Shield patients needing to see UMMC specialists appear to have their hands tied since the two organizations’ legal battle began in April.

Local pediatricians said they were dealing with the fallout.

“Our referral coordinators got a lot of calls about what patients could do to get their follow-up appointments,” said Dr. Darren Scoggin of Children’s Medical Group.

Pediatric groups in the area said they have adjusted treatment plans due to the ongoing battle, particularly regarding referrals.

“Because Batson Children’s Hospital is the only children’s hospital in the state, we need a lot of specialized pediatric services there,” Dr. Scoggin explained.

At the Children’s Medical Group of Jackson, two referral coordinators are hard at work finding new providers for BCBS patients in the area.

“We have a dedicated referral specialist who can navigate this system because there is a lot of paperwork involved, a lot of phone calls involved and a lot of time spent with patients and referral centers whether ‘UMMC or private centers,’ said Dr. Scoggin.

However, since Children’s Hospital is the only place in the state where many patients can get the care they need, referral coordinators look a little more for places that are within reach.

“Patients who are out of network at UMMC have the option of paying out of pocket or going to their insurance company, but if we can’t get that we are happy to help them find other pediatric specialists, either in-state or out-of-state,” Dr. Scoggin said.

The pediatricians said that despite the mediation, the two organizations were helping them find ways to care for the patients.

“Many of the specialists at UMMC have worked very well with our patients proactively to either provide them with the refills they need until this is resolved or try to find a way to cover the visit if needed until until the arbitration is completed and Blue Cross and UMMC can come to an agreement,” Dr. Scoggin said.

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