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WellNow Urgent Care stops accepting Excellus insurance after companies fail to reach agreement

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  • Staff Report 

In a significant shift in healthcare service options across the Finger Lakes WellNow Urgent Care has stopped accepting Excellus BlueCross BlueShield insurance.

The decision, announced by Excellus late Sunday, follows what the insurance giant describes as extensive yet unsuccessful contract negotiations.

“Excellus BlueCross BlueShield has made every effort to engage in good faith contract discussions with WellNow Urgent Care so they would remain in our network in 2024,” the company said in a statement. “WellNow, however, has declined our latest offer, which included an increase in reimbursement. WellNow will be removed from our provider network effective Jan. 1, 2024. While we are disappointed by their decision, we’re prepared to help our members find the care they need.”

The disagreement dates back to October when WellNow first indicated the potential discontinuation of their partnership with Excellus, emphasizing a need for updated reimbursement rates that reflect their service costs and value.

Dr. Michael Biernbaum, Chief Medical Officer for WellNow, said the issue with reimbursement rates ultimately came down to classification. In addition to the urgent care chain operating for years without updated rates, Excellus also used a classification metric that compared their services to a primary care office to determine reimbursement.

Simply put, Dr. Biernbaum said WellNow is far from a simple primary care office, even if a large number of patients utilize urgent care settings as a replacement to primary care. Not only that, but healthcare costs across the region will likely jump thanks to the lack of agreement between the two.

“It will cost everyone more if WellNow patients who have Excellus are forced to visit emergency rooms or delay care entirely,” he told last month. “Whether you’re talking about six hour wait times to be seen at an emergency room, or the sheer cost — thousands of dollars per visit — the cost to all parties involved is less if we have a deal in place to keep Excellus patients ‘in-network’.”

The termination of this relationship has prompted concern among policyholders, who will now have to bear out-of-pocket expenses for services at WellNow.

Excellus officials stood firm on the refusal, stating that WellNow’s demands were unfeasible and accusing them of leading an aggressive campaign against them. This development marks a significant change for members of BlueCross BlueShield, who may now face increased healthcare costs and limited options.