MOUNT VERNON — Contract negotiations between physicians employed by Knox Community Hospital and Anthem/Blue Cross/ Blue Shield are at an impasse, and the contract will be terminated as of Oct. 1.
That means services provided by those physicians will be out-of-network and may result in higher costs to patients who are currently insured through Anthem.
Bruce White, chief executive officer at KCH, said the contractual arrangements for the services provided at the hospital are different from those arrangements with payers for employed physicians, so in-patient and out-patient hospital charges will still be considered by Anthem to be in-network. The issue, he said, is with the 29 hospital-employed health care providers, which include, but are not limited to hospitalists, surgeons, anesthesiologists and other specialists.
“For those Anthem patients that are using the hospital-employed physicians,” he said, “it will impact their out-of-pocket. Anthem will begin to adjudicate their claims based upon Anthem’s out-of-network fee schedule.”
Kim Ashley, public relations director, Anthem Blue Cross and Blue Shield in Ohio, said, “They came to us requesting an increase in reimbursement that is simply unsustainable for our customers. When we tried to negotiate a lower rate, they made the decision to terminate the contract.”