Mid-Atlantic Women’s Care and Anthem Blue Cross and Blue Shield disagreement over reimbursement rates

Published: Jul. 13, 2023 at 7:18 PM EDT|Updated: Jul. 13, 2023 at 7:46 PM EDT
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HARRISONBURG, Va. (WHSV) - Mid-Atlantic Women’s Care and Anthem Blue Cross and Blue Shield are in negotiation over reimbursement rates but are struggling to find a mutual agreement.

If there is no resolution, their agreement will be terminated at the end of the month. Harrisonburg OBGYN is part of Mid-Atlantic Women’s Care and could be impacted if negotiations are not settled.

“Every several years insurance companies negotiate with doctors, practices, hospitals, etc. on their reimbursement rates and this has been happening for decades,” said Dr. Cathy Slusher, with Harrisonburg OBGYN and Mid Atlantic Women’s Care Affiliate.

Dr. Slusher said in the past Harrisonburg OBGYN has been a small practice and had to accept whatever reimbursement rate was given.

“Recently we have joined a business relationship with Mid-Atlantic and we are in contortion with many practices across the state. So there is a statewide group of OBGYNs that can come together with a loud voice,” said Dr. Slusher.

Dr. Slusher said negotiations are still ongoing and nothing is a done deal.

“We are holding very firm to try to be reimbursed appropriately for the care we provide this community. We are not asking for overt or to be overly compensated we just ask to finally come to the table with what other places are getting that have bigger voices,” said Dr. Slusher.

In a statement, Anthem said Mid-Atlantic is demanding a significant cost increase more than other providers in Virginia and this would place a burden on the people and employers in Virginia.

Anthem said if Mid-Atlantic continues with their decision to leave the network, disrupting their own patients’ care, they will work with members to provide ample access to healthcare providers that offer affordable, quality care in a safe space and comfortable environment.

They noted that Mid-Atlantic is the only group it has worked with that has threatened to leave the network over reimbursement rates.

Dr. Slusher said if you are currently pregnant or have a scheduled procedure after the first, you will still be covered.

“Pregnancies, scheduled surgeries, everything that is active will be covered until the end of that event,” said Dr. Slusher.

Dr. Slusher said she understands people’s frustrations and hopes to work something out soon.