Syracuse, NY -- Excellus BlueCross BlueShield members will be charged sharply higher fees at WellNow urgent care centers starting today after the two sides failed to reach a contract agreement over the weekend.
That means that people insured by Excellus will now pay a walk-in fee of $165 at WellNow, plus out-of-network fees for any additional services provided. That compares to a small co-pay under the terms of the now-expired contract.
Excellus issued a statement late Sunday night confirming no agreement was reached on a new contract with WellNow:
“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. 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.”
Excellus said its members can visit ExcellusBCBS.com/CareOptions to learn about options for care, including information on primary care doctors, telehealth and urgent care.
WellNow also confirmed no deal has been reached.
The two sides have been at odds for months over reimbursement rates for care at the region’s sole chain storefront provider of urgent care.
The contract affects thousands: Excellus covered roughly 90,000 visits to WellNow in Onondaga County alone in 2022, the urgent care company said. Statewide, Excellus covered 300,000 WellNow visits last year.
WellNow provides a “safety net” for those too sick to stay at home, but not ill enough for an emergency room, said Tom Dennison, a retired Syracuse University professor and healthcare expert.
The clinics are also a top choice for people who don’t have a primary provider.
A handful of other urgent cares in Onondaga County remain covered by Excellus for specific situations: there are two pediatric urgent cares and two orthopedic urgent cares, for injuries like sprains and broken bones.
Without a WellNow contract, however, there are few good choices for other Excellus members, according to local health experts:
- Pay the higher fees at WellNow
- Find a different urgent care (that is likely further away)
- Wait in line at an emergency room (which takes the most seriously ill patients first and can cost much more in the long run)
- Go without care and hope for the best
It’s unclear how much of an impact the standoff would have on already overburdened ERs and doctor’s offices.
One of Central New York’s major primary care providers, Family Care Medical Group, says that it is prepared to handle more sick visits, with priority going to those with the most acute needs.
For now, the group of roughly 50 physicians isn’t planning any changes. But it could expand weekend and evening hours, if needed, said CEO Dr. Mitchell Brodey, who is also a medical professor at SUNY Upstate.
Still, that may not be enough, he added.
“A lot of primary care offices are full,” Brodey said. “It’s hard to find staff. In a perfect world, we would all take care of these patients. We will work to accommodate them.”
The people who rely on urgent care the most are those who can’t find a primary care doctor or chose not to, he added. For those people, urgent care or the ER is the only place to get care.
Excellus members who plan on paying out-of-pocket for WellNow might still get some coverage, but it will be at much higher “out-of-network” rates, the insurance company said. Members should log into their online account to review their out-of-network benefits or call customer service for more information.
Depending on coverage, paying WellNow’s out-of-network rates might still be cheaper than the co-pays for an emergency room visit, Brodey noted.
For those looking for urgent care options that remain in Excellus’s network, there are a few options:
In Syracuse, the only general urgent care is Quick Care, run by Syracuse Community Health, at 819 S. Salina St.
There are two nearby pediatric urgent cares: Drakos Pediatric Urgent Care, at 8100 Oswego Road (Route 57) inside Clay Medical Center and the Golisano Pediatric Urgent Care at 4900 Broad Road, inside Upstate Community General Hospital.
Upstate Orthopedics also runs a bone and joint urgent care, which can be accessed by calling (315) 464-4472. Its main facility is at 6620 Fly Road, DeWitt. And SOS Plus operates an orthopedic urgent care at 5719 Widewaters Parkway, in DeWitt.
Oswego Health runs two general urgent cares, in Fulton and Central Square. The Fulton location is at 510 S 4th St. The Central Square location is at 3045 East Ave. That puts at least one of them within a short drive from most locations in the northern suburbs.
Auburn Memorial Hospital also runs an urgent care in Skaneateles, at 803 W Genesee Street Road, just inside the Onondaga County line.
The closest urgent care to the east is Oneida Health’s Quick Care, in the city of Oneida, at 357 Genesee Street.
Staff writer Douglass Dowty can be reached at ddowty@syracuse.com or (315) 470-6070.