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Tyler Hospital Files Lawsuit Posted on   

FOR IMMEDIATE RELEASE   Tyler Hospital Files Lawsuit Challenging Major Health Insurance Provider Tyler, TX (November 12, 2014)—Texas Spine & Joint Hospital filed a lawsuit in Smith County today against BlueCross and Blue Shield of Texas (BCBS), a division of Health Care Service Corporation. In the suit, Texas Spine & Joint Hospital seeks damages for years of disputed payments for patient care provided to BCBS members. Further, the hospital argues that BCBS is in violation of the Texas Free Enterprise and Antitrust Act by having only one contracted or “in-network” hospital facility in the Tyler, Texas, area. BCBS has taken the position that only one hospital in Smith County should be in network with BCBS. “Our goal is to be able to allow BCBS members to access our expert care without worry as to what their insurance may pay,” states Tony Wahl, Texas Spine & Joint Hospital CEO. “We believe there is a strong patient demand to have more than one hospital in network with BCBS, as most if not all other payors in this market contract with more than one hospital.” Texas Spine & Joint Hospital ranks among the Top 100 hospitals nationally for Patient Satisfaction and is in the Top 10% nationally for Medical Excellence in multiple categories according to CareChex, a division of Comparion. Since opening in 2002, Texas Spine & Joint Hospital has continually worked towards contracted status with BCBS and sought reasonable reimbursement for care provided to BCBS members. According to hospital administration, all attempts to resolve the issue administratively have been exhausted or proven futile. During the lawsuit, Texas Spine & Joint Hospital will continue to accept BCBS members and access will not be affected. Texas Spine & Joint Hospital administration makes note that the lawsuit is strictly between the hospital and BCBS. The actions of the suit are not intended to be detrimental to area healthcare providers who are currently contracted with BCBS. Texas Spine & Joint Hospital is a privately owned hospital specializing in orthopedic and spine surgery, procedures, and tests. TSJH includes a fully licensed acute care hospital, an outpatient surgery center, two walk-in clinics, and an ancillary imaging center. With a total medical staff of over 196, TSJH employs 300 full and part time employees. Recently, TSJH received a Gold Award from the TMF Health Quality Institute and was included by Becker’s Hospital Review on their list of hospitals with great orthopedic programs.