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GREENSBORO — While Moses Cone Health System and Blue Cross and Blue Shield of North Carolina argue over money, people covered by Blue Cross who want to be able to use Cone's medical centers wait and worry.

Cone has canceled its contract with Blue Cross, the state's largest insurer, effective Nov. 1. The two organizations could not agree on how much money Blue Cross would pay Cone for services it offered or the length of the contract. Two weeks after Cone's announcement, nothing has changed.

"They're not returning our calls," Doug Allred, a spokesman for Moses Cone, said this week.

"We don't negotiate where a termination notice is in effect," said Blue Cross spokesman Mark Stinneford said.

As it stands, the roughly 120,000 people in Guilford County who are covered by Blue Cross would pay higher, out-of-network costs after Oct. 31 if they use Moses Cone, Women's Hospital, Wesley Long Community Hospital or Annie Penn Hospital in Reidsville.

By law, however, trips to emergency rooms must be covered at in-network rates, so that people needing emergency care can use the closest hospital without insurance worries.

Among the people affected by the standoff are state employees in the area — school teachers, state law-enforcement officers and court clerks, university employees. The county school system alone has more than 6,300 employees covered by Blue Cross — between 8,000 and 10,000 when employees' family members are included. Some of those people are covered by a Blue Cross indemnity plan that is not part of the contract.

"We do have a lot of worried employees," said Patty Kinkade, director of benefits for Guilford County Schools. "We are getting a lot of phone calls, so we really do hope this gets settled."

Doctors aren't affected, but their patients are.

"This is a community issue because Blue Cross is a huge player in this community and (Moses Cone Health System) is a monopoly," said Susan Wolf, practice administrator at Wendover OB/GYN & Infertility in Greensboro, almost half of whose obstetric patients are insured by Blue Cross. "We have such a small choice of payers, and I think patients and employers are all caught in the crossfire."

The crossfire is this: With a contract ending, Moses Cone is seeking more money from Blue Cross for care it provides to those insured by Blue Cross. Blue Cross is trying to get Cone to agree to less money than Cone wants.

The hospital says Blue Cross's offer is unreasonably low and will rob it of money it needs for quality care and for investment in future needs. It says Blue Cross's position would fatten profits at the expense of patient care.

The insurer says Cone is overpriced and, according to Stinneford, will be getting a

36 percent increase anyway between July 1, 2007, and July 1, 2009. Blue Cross members generate between 16 percent and 18 percent of Cone's revenue.

The hospital also claims Blue Cross is insisting that it pay less money for comparable services than all other insurers with which Cone does business and that such an arrangement means people covered by other insurers are subsidizing the costs of Blue Cross patients.

Stinneford says Blue Cross is indeed using its size as leverage but that it's just trying to keep health care costs, and thus patient premiums, down. According to its Web site, the insurer believes meeting Cone's demands would require it to raise premiums 5 percent for Triad members.

Consumers and employers have little recourse but to wait for the two agencies to negotiate. The Department of Insurance does not get involved in contract disputes, spokeswoman Chrissy Pearson said.

Details of existing contracts are not public.

What's likely to happen? The parties aren't saying, but Blue Cross is giving its customers information on hospitals within an hour's drive of Greensboro with whom it has contracts.

Stinneford also recalled when Blue Cross was in the same situation in 2005 with Wake Forest University Baptist Medical Center.

"Shortly after (the contract ended), Baptist approached us and we were able to work out a new agreement," he said. "But they were actually out of our networks for a brief period."

Wake Forest/Baptist spokesman Mark Wright confirmed that period lasted about three months before the medical center reached an agreement with Blue Cross.

"We need to maintain a relationship with insurance companies that represent our patients," he said. "We want to serve patients the best way we can, and that is one way to do it."

It's unclear whether a similar scenario could play out between Blue Cross and Cone, and that uncertainty worries Beth McKinney, whose family is insured by Blue Cross through her husband's employer, Unifi.

"All of our doctors are affiliated with Moses Cone, so if Blue Cross Blue Shield severed their relationship with Moses Cone, then we'd need to find doctors who have (admitting privileges) for High Point Regional," she said. "I guess I'm being optimistic in hoping they'll work it out, but who knows?"

Contact Lex Alexander at 373-7088 or lalexander@news-record.com