Insurance Contract to Expire Between Augusta Health and Anthem Blue Cross Blue Shield

By: Karen Campbell Email
By: Karen Campbell Email

First it was gas prices, then food and now it's your emergency room bill.

Depending on who you have insurance with, getting emergency care at Augusta Health could cost you more.

That's because Anthem Blue Cross Blue Shield is ending its contract with Shenanoah Emergency Medicine Specialists - or ER physicians at Augusta Health.

The changes will take effect May 1.

Anthem states the ER group wants more for reimbursement rates, more than what Anthem can cover.
Skylar Saunders lives in Waynesboro and uses Anthem Blue Cross Blue Shield as her primary insurance company, but if she needs to go to the emergency room, she could be hit with a hefty bill.

"I think it's ridiculous that they are not providing services to their local people here in the Waynesboro, Augusta county community. The fact that we have to drive a distance to the closest ER is just ridiculous," said Saunders.

Since the contract between the two groups will expire, that means if a patient wants to be covered by Anthem, he/she has to travel to Rockingham Memorial Hospital in Harrisonburg, or hospitals in Charlottesville to be treated by an emergency physician.

Doctor Fred Castello, chief medical officer at Augusta Health released a statement reading in part:
"Augusta Health will remain “in network” so that any surgery, lab testing, imaging studies, hospital portion of Emergency visits, etc. that patients seek here will be covered. The only portion that may not be covered is the Emergency Physicians professional fee."

"It is the worst time. I mean, gas is nearing $4 a gallon. Now I have to think, 'Do I really need to go to the ER?'" said Saunders.

Saunders says many people may question if they really need services.

"Can I just wait until tomorrow to go to the ER or can it wait. Had you gone to the ER things could have been prevented but you had to think about your finances and how much debt this was going to put you into. That's just not OK, it's not right... for a local hospital to do that to us it's not OK," said Saunders.

It is important to mention that the move will not affect Anthem HealthKeepers and Anthem HealthKeepers Plus HMO networks or members in these plans.

According to Anthem, Shenandoah Emergency Medicine Specialists wanted reimbursement rate increases of 37 percent to 78 percent "above our standard rates for ER visit codes."

Anthem stated that while the termination may be an inconvenience to members, the company has established a hot line to address questions and concerns.

That number is 1-866-263-0361.

Hospitals that will be accepting Anthem insurance include: Rockingham Memorial Hospital, UVA Medical Center and Marth Jefferson Hospital.

Urgent Care Centers that will accept Anthem insurance include: Augusta Health Outpatient Center, Urgent Care, Weyers Cave; AH Convenient Care Clinic in Waynesboro and Staunton.


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