This site has some features which use javascript. Please turn javascript on in your browser. Important Notice for Wayne County Customers | BCBSNC

Wayne Memorial Hospital and Blue Cross and Blue Shield of North Carolina Reach New Agreement

GOLDSBORO, NC -- Wayne Memorial Hospital and Blue Cross and Blue Shield of North Carolina today announced a new, three-year contract effective immediately. The new contract means that BCBSNC customers can resume receiving care at Wayne Memorial Hospital and with their physicians on an in-network basis.

"We're pleased to announce a new contract with Blue Cross that protects our patients' ability to access our care with no barriers," said William Paugh, President and CEO of Wayne Memorial Hospital. "As with any extended negotiation, neither side is totally satisfied, but you can be sure that Wayne Memorial Hospital's commitment to serving our patients is as strong as ever. These negotiations were frustrating for the hospital and for our community, yet they were important in our ability to provide Wayne County residents access to clinical excellence and patient-centered care well into the future."

"We appreciate the community's patience while we worked to gain agreement on a new contract. These efforts reflect BCBSNC's commitment to keep health care as affordable as it can be for our customers while working to support independent community hospitals," said BCBSNC President and CEO Brad Wilson.

As a result of the new contract, BCBSNC customers can resume using Wayne Memorial Hospital as an in-network facility. For questions or more information, patients can call Wayne Memorial Hospital at (800) 605-3988, or call BCBSNC at the number listed on the back of their insurance card.



Log in to find an in-network doctor or facility.

Not a member? Register.



Claim vs. Fact

Claim: Wayne Memorial was surprised by BCBSNC's decision to end its contract.

Fact: The hospital's claim that they were unaware of BCBSNC's intention to end the contract is difficult to understand. BCBSNC notified the hospital on Aug. 4, 2013 that we were canceling our contract effective Dec. 5, 2013, if a new agreement was not reached within the next 30 days. BCBSNC notified Wayne Memorial in writing again on Sept. 4, 2013, and called the hospital's chief financial officer before contacting our customers or the media.

Claim: Wayne Memorial provided a counterproposal with additional concessions.

Fact: Wayne Memorial Hospital's best offer to BCBSNC demanded that our customers pay guaranteed annual increase higher than any other hospital in the state on top of rates for outpatient care that were already significantly higher than the statewide average.

Claim: Wayne Memorial has low charges compared to other hospitals.

Fact: As Wayne Memorial is aware, discussing "charges" is meaningless in a conversation about what customers actually pay. That's merely the list price, similar to a car's sticker price. BCBSNC negotiates discounts on its customers' behalf, and Wayne Memorial's discount is a fraction of the discount other hospitals provide. This means customers pay far more out of pocket at Wayne Memorial than they do at other nearby hospitals.

Claim: BCBSNC insists that Wayne Memorial sign a contract that gives BCBSNC complete control over rates.

Fact: Not true. BCBSNC has asked Wayne Memorial to agree that rate increases would be mutually agreed upon.

Claim: BCBSNC refused to negotiate with Wayne Memorial Hospital.

Fact: Negotiations with Wayne Memorial began more than a year ago. BCBSNC made multiple attempts to secure a contract that provided high-quality care and reasonable rates for our customers. Unfortunately, those negotiations were unsuccessful.


How This Change Affects BCBSNC Customers

Which customers are affected by this decision?

Effective Dec. 5, 2013, Wayne Memorial Hospital will become an out-of-network facility for most BCBSNC customers including State Health Plan members (January 2, 2014 for Federal Employee Program members). These contract changes do not affect Blue MedicareSM / Medicare Advantage customers.

Where will Wayne Memorial Hospital patients go when the contract ends on Dec. 5, 2013?

In case of an emergency, BCBSNC customers should always go to the nearest hospital. Emergency care is always covered at the member’s in-network benefit level, and prior authorization is never required.

BCBSNC has contracts with other hospitals in the Eastern region of the state where BCBSNC customers can go for more affordable, high-quality medical care. There are 34 in-network hospitals within driving distance of the Wayne County area.  The five in-network hospitals closest to Wayne Memorial Hospital are:

  • Lenoir Memorial Hospital
    Kinston, Lenoir County (19.7 miles)
  • Wilson Medical Center
    Wilson, Wilson County (24.0 miles)
  • Johnston Memorial Hospital
    Smithfield, Johnston County (24.5 miles)
  • Duplin General Hospital
    Kenansville, Duplin County (28.1 miles)
  • Vidant Medical Center
    Greenville, Pitt County (32.4 miles)

What if I have an emergency?

In the event of an emergency, BCBSNC customers should always seek treatment at their nearest hospital, regardless of where they are. Emergency care is always covered at the member’s in-network benefit level, and prior authorization is never required.

What is BCBSNC doing to help customers transition to a new in-network hospital?

BCBSNC will communicate with all customers, including State Health Plan and Federal Employee Program customers in the Wayne County area about the contract situation with Wayne Memorial Hospital. This information will include alternative locations in the immediate area that provide more affordable, high-quality care.

Certain members who meet BCBSNC continuity of care guidelines will be able to continue receiving in-network benefits for certain types of care received at Wayne Memorial Hospital for a limited period of time. In November, BCBSNC contacted its customers who were identified as potentially qualifying for continuity of care. 

Where should patients who are pregnant or currently seeking treatment for a chronic illness go for hospital care?

BCBSNC is prepared to work with physicians and customers to make access to services at area in-network hospitals easier during this time, if needed. All BCBSNC customers in the Wayne County area will receive information about more affordable, high-quality in-network hospital alternatives in the immediate area.

In the event of an emergency, BCBSNC customers should always seek treatment at their nearest hospital, regardless of where they are. Emergency care is always covered at the member’s in-network benefit level, and prior authorization is never required.

What implications (if any) will the end of the Wayne Memorial Hospital contract have on the State Health Plan or the Federal Employee Program?

Effective December 5, 2013, Wayne Memorial Hospital will become an out-of-network facility for most BCBSNC customers, including State Health Plan members. All BCBSNC customers in the Wayne County area will receive information about more affordable, high-quality in-network hospital alternatives in the immediate area.

What impact will the end of the Wayne Memorial Hospital contract have on Federal Employee Program (FEP) employees in the Wayne County area?
We will continue to provide benefits for covered services from Wayne Memorial Hospital at the Preferred level for 90 days from the date of written notification October 2, 2013 to our FEP members.

If you have Standard Option and you receive services at Wayne Memorial Hospital after January 2, 2014 (90 days from date of notification to FEP members), benefits will be provided at the Non-Preferred level.  As a result, your out-of-pocket expenses will be higher than if you went to a Preferred hospital.

If you have Basic Option, benefits are not available for care performed by Non-Preferred providers except in certain situations, such as emergency care. Therefore, Basic Option benefits will not be paid for care received at Wayne Memorial Hospital after January 2, 2014.

® SM Marks of the Blue Cross and Blue Shield Association (BCBSA). © 2013, Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. U9552, 9/2013.