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CNYers with Excellus BCBS weigh urgent care options with WellNow out of network

A piece of white paper with words printed on it.
Scott Willis
This letter was sent to an Excellus BCBS member and WellNow customer before year's end.

Tens of thousands of Central New Yorkers might be seeking other urgent care options now that the WellNow Urgent Care chain is out-of-network for Excellus Blue Cross/Blue Shield members. They were unable to reach an agreement with WellNow on reimbursement rates before the January first deadline. That means patients will pay much higher rates and fees if they seek care at WellNow. Doctor Wajeeh Sana is medical director and chairman of emergency services at Oswego Hospital. He says urgent cares do fill a need in the community for non-life threatening illnesses or injuries.

“If you have cold like symptoms, if you have a cough, you think you got bronchitis, sinus infection, minor sprains, small cuts.”

He says in his area, there are other urgent cares in Fulton and Central Square, and both accept Blue Cross/Blue Shield. But Sana says to check with any provider about coverage before receiving care.

“Please inquire upfront so you're not surprised by the bill that is not covered afterwards and if your insurance is not covered, you might have to pay out of your pocket.”

Sana says if your symptoms don’t need immediate attention, it might be best to check with your primary care physician.

“A lot of primary care providers office will have sick calls built into their schedules, and I think they will be happy to accommodate you if same day. If not, maybe the next day.”

Sana says telehealth and telemedicine might also be an option, where a doctor or nurse might be able to walk you through self-care or treatment without a visit to the office. On the other hand, Sana says to head to the hospital emergency department if you have life-threatening symptoms.

“If somebody is experiencing chest pain, abdominal pain, stroke like symptoms, if you have fallen and you think you may have broken a bone, shortness of breath, all those things are ER appropriate.”

Excellus Blue Cross/Blue Shield offers much the same advice. The insurer urges patients to have a plan in place before they need immediate care, though it is well-aware of the that urgent care plays a significant role. Excellus estimates that most members have used WellNow at least once or twice over the course of a year.

Scott Willis covers politics, local government, transportation, and arts and culture for WAER. He came to Syracuse from Detroit in 2001, where he began his career in radio as an intern and freelance reporter. Scott is honored and privileged to bring the day’s news and in-depth feature reporting to WAER’s dedicated and generous listeners. You can find him on twitter @swillisWAER and email him at