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'If you’re sick, you don’t feel like fighting this.' Cancer patient opts to not get scans as price skyrockets

Radiologist
Posted at 4:45 PM, Apr 21, 2021
and last updated 2021-04-27 10:14:16-04

FRANKLIN, Tenn. (WTVF) — UPDATE: “Following the story, Radiology Alliance has made contact with patient Pamela Navarra to inform her she can get her scans and the rest of her care with them in-network. They confirmed they are committed to working with her, and other patients, through this time to offer in-network prices. They also dispute the price estimate the couple was given on the phone.”

A cancer patient has decided to not get life-saving scans because her bill has skyrocketed after a contract between Radiology Alliance and BlueCross BlueShield of Tennessee ended.

Pamela Navarra doesn't know how long she has to live because she has cancer and other health issues. "It’s hard to see her health decline," her husband, Philip Navarra said.

Philip found out Pamela's cancer scans are now out-of-network. He was told it would cost $1,500 out-of-pocket, so Pamela decided to not go to the appointment since they didn’t budget for that cost. "You know, I don’t mind walking away from a scan at this point, but others may not," Pamela said. "If you’re sick, you don’t feel like fighting this, and it’s just not fair."

Dr. Mark Shaw with Radiology Alliance says he's disappointed this happened during the pandemic as it could impact 80,000 patients in the middle of the year. "They haven’t come to the table in a meaningful way to negotiate an in-faith contract with us," Dr. Shaw told us. "We aren’t asking for any increase in pay, we’re just asking for continuation of the same contract that had been in force for the last 20 years."

A spokesperson for BlueCross BlueShield of Tennessee issued a statement: "We value Radiology Alliance providers as partners in providing services to our members, and we will continue our efforts to reach an equitable agreement. We hope we can find consensus soon."

Philip said he's called both companies for help. "We’re not trying to take sides, we just feel like we’re little people caught in the middle," Navarra said, "And you know we went back and forth, and back and forth with the blame game, pointing fingers at each other."

Pamela said her fight is nearly over, so her main concern is how this impacts other people who are sick if they don't have the will to fight the system. "There’s going to be a lot people saying I’m getting a bill for radiology? I thought I was covered," Navarra said.

This could also impact COVID-19 long haulers who need lung scans if they have this insurance plan. The majority of hospitals in the area use radiologists with Radiology Alliance, excluding Vanderbilt University Medical Center. To note, BlueCross Medicare Advantage members can continue to access Radiology Alliance providers in-network.

Patients can go here for more information, and to fill out a form for assistance. Resources can also be found on the BCBSTFacts website including lists of alternate facilities with in-network radiology providers.