Small Town Doctor Vs. Big Time Insurance - KAIT Jonesboro, AR - Region 8 News, weather, sports

OSCEOLA -- HEATHER FLANIGAN REPORTS

Small Town Doctor Vs. Big Time Insurance

December 23, 2003 -- Posted at 5:53 p.m. CST

OSCEOLA --Dr. Reggie Cullom says that his patients are like his family, and he's been practicing medicine for over 30 years, so you can guess how big his extended family has become. He sees about 3200 families in the surrounding area.

"I don't see strangers, I see people I know and I'm going to bump into them tomorrow, or the next day or the next day," said Cullom.

Patients in Mississippi County are familiar with Dr. Cullom. He's one of seven doctors in the town of 10,000. He's also one of the few doctors that makes house calls.

Stefanie Smithey says that Dr. Cullom was responsible for saving her husbands life after he suffered a heart attack.

"He made all of the arrangements and had him transferred to Memphis and I still have him. But we can all tell stories like that. The problem is we've become such a big country, yet we still have people who are dictating. I feel like it's (the movie) John Q. all over again," said Smithey.

His patients started receiving letters from Blue Cross Blue Shield in October stating that Dr. Cullom had received a termination notice.

He did receive a certified letter, on December 3rd, reading that as of January 1, 2004, he would no longer be a provider for Health Advantage, Arkansas First Source and U.S. Able. But there are no answers to why...and according to Dr. Cullom, they've never given a reason.

"Since November of 2001, I have heard nothing from insurance companies, nothing what so ever. We battled them saying we were giving too many shots and too many x-rays, and we battled that battle then. Normally they go through a six month review, they had me on review for three years and they didn't find anything," said Dr. Cullom.

It was a patient that brought the news to Dr. Cullom about his appeal process.

"I guess she knows something here that I don't know," laughed Dr. Cullom.

The note reads: Dr. Cullom did receive a termination notice on December 3rd, but is appealing his termination notice on January 15th.

"I don't know about a January 15th meeting. I have never received anything. I had to read her letter to find out that I'm supposed to be in Little Rock on January the 15th," said Dr. Cullom, surprised.

But those folks that Dr. Cullom sees are worried that he will have to close down his practice. If Blue Cross Blue Shield refuses to have him as a provider....he becomes an out-of-network doctor, and some patients would simply not be able to afford to see him.

Robin Lloyd is a patient of Dr. Cullom, and says it's confusing.

"To us that's admitting, we'll it's ok for you to use him, he's an ok doctor, but we're going to charge you, you know, we're going to make it outrageous for you," said Lloyd.

But Stefanie Smithey isn't sure what her family will do if Dr. Cullom shuts his doors. Some of the other doctors in town aren't accepting new patients. She may have to take her family to Blytheville, West Memphis or Jonesboro.

"Some of us will probably sell our homes and move to where we have more choices in doctors and we have the option, because you are taking us down to a very minimum amount. Some of us have family members with serious illnesses that can't afford to be that far from a doctor," said Smithey.

A few supporters say they may have to change insurance providers...

"To be told this, it won't work. Blue cCoss won't have us any longer if that's the way they choose to do," said Lucy James.

In the meantime, Dr. Cullom waits for his appeal date with Blue Cross Blue Shield, and has prepared his staff of eleven that the doors could close.

"I don't know, I honestly don't know. I've never been told what I did wrong or what they expect of me," said Dr. Cullom.

A spokesperson for Blue Cross Blue Shield was reached on Tuesday. While they were unable to comment on why Dr. Cullom is being terminated as a provider, they did say that his patients would continue to receive the maximum benefits during his appeal process.

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