Valley Children's and Sante dispute has parents scrambling for health care
Valley Children's spokesperson Zara Arboleda says the hospital is going around Sante and working directly with the insurance companies. One has already agreed to deal.
FRESNO, Calif. (KFSN) -- The dispute between Valley Children's Hospital and Sante Medical Group has been a big problem for pediatricians like Dr. Amy Evans and her young patients.
"Our children are getting denied getting X-rays and ultra-sounds and MRI's if they have this particular type of insurance," said Dr. Amy Evans. "Some patients are being asked to go to the Bay Area, or travel to the Bay area for basic access to care for specialty services."
The hassles are because the agreement between primary care doctors, like Evans, and the specialists at Valley Children's Hospital is expiring at the end of this month, and Valley Children's is not accepting patients covered by the HMO policies covering Sante Patients. Valley Children's spokesperson Zara Arboleda says the hospital is going around Sante and working directly with the insurance companies. One has already agreed to deal.
Arboleda said, "Our hope now is to come to agreements with all the insurance companies directly so that those patients can continue to come here."
Sante director, Dr. Daniel Bluestone blames a Valley Children's for the conflict. "We've agreed to pay Valley Children's Hospital whatever they demand, We've jumped through all the administrative hoops and overcome the barriers they've put up and we are working with the HMO health plans to make sure those kids get the care that they need."
But part of the solution is expanding the pediatric care offered by Sante doctors through Community Regional Medical Centers.
Dr. Daniel Bluestone explained, "We are now in a position where we have no choice but to build our own pediatric specialty group there are some critical specialties we don't have we are going to need to take care of the kids here in Fresno."
That could further antagonize Valley Children's, since they are being forced into competition with Community and Sante for pediatric care. Dr. Evans says she doesn't understand the politics behind all of this, but wants both sides settle their differences soon.
"I'm hoping they are fixing the problem but I am a little dubious they are actually doing it," said Dr. Evans. "But I certainly hope they do because it's really affecting the quality of care in the Central Valley."
