Father of Phoenix Children's Hospital patient left frustrated as dispute with Blue Cross Blue Shield continues

PHOENIX - It's been close to two weeks, and officials with Phoenix Children's Hospital say a deal with Blue Cross Blue Shield in the short term is unlikely.

We first reported on the dispute in October, when officials with Blue Cross Blue Shield Arizona say the hospital gave notice of their intent to leave the network. The decision took effect on Oct. 31.

Similar dispute affected one family before

The dispute has left some families in flux, including a family that went through something similar in 2023.

For Eric Koziatek, however, this dispute feels different, and he has no idea what they are going to do.

"This tumor will be part of him for the rest of his life," said Eric, referring to his 10-year-old child.

Eric's child has been battling a tumor behind one of his eyes, and he takes night chemo pills to keep the tumor in check. Eric's child, however, still requires quarterly MRIs and a trusting relationship with his doctors.

As mentioned above, this is not the first time Eric has dealt with something similar. In 2023, his family had UnitedHealthcare, which was involved in a separate dispute with PCH. On June 1, 2023, however, the two sides reached a multi-year deal. Eric is going through it all over again after his employer switched insurance providers.

"Seems like it’s a regular game that the insurance companies and the providers play with each other," said Eric.

Hospital, insurance providers speak out

Officials with Blue Cross Blue Shield said "to avoid disruption for our members, AZ Blue agreed to Phoenix Children’s financial demands. Phoenix Children’s still said no, and turned down an $80 million raise."

Phoenix Children’s, meanwhile, called that a fabrication, saying "a new agreement in the near term seems unlikely. We know it can be difficult to be out of network, and we want families to know we are fighting for an agreement that puts the health care needs of their children first."

"They are kind of chicken, I think, in that both sides will, you know, maybe take a certain position until the very last minute, and then try to come to an agreement and this time, we don’t have an agreement," said Kathy Hempstead with the Robert Wood Johnson Foundation.

Eric's son is headed for another MRI in December, and officials with Blue Cross say they will pay to complete a kid's course of treatment. However, as Eric's son will need treatment the rest of his life, the family does not know what will happen.

"You have to weigh the cost vs. the unknown, in the fear of another doctor," said Eric. "Quite honestly, we don’t know what we’re gonna do."

Analysts say this won’t be the last time this happens, as hospitals and insurance companies continuously negotiate deals.