Anthem decision puts two Reid Health Connersville locations out of network
Reid Health system officials say they are surprised by Anthem's decision to refuse to include two recently added Connersville facilities to existing contracts between Reid and the insurance provider -- leaving a number of commercially insured Anthem customers out-of-network for some Reid services in Connersville.
The situation affects the
services Reid Health provides in two locations acquired as part of Reid's
purchase of most of the assets of Fayette Regional Health System in July: the
main campus at 1941 Virginia Avenue and Reid Health Care Pavilion on Erie
Avenue. It does not affect Reid Health's longstanding locations on Highway 44
in Connersville or any recently added Reid Health Physician Associates offices.
are disappointed Anthem would not add all of the new locations to our existing
contract, which we believe should allow us to add new sites of care," said
Craig Kinyon, Reid Health President/CEO. "In our discussions with Anthem
officials, they are so far unwilling to include these locations as part of the
established reimbursement rates with previously existing locations in
Connersville and in Richmond. We are only asking for reimbursement at the same
rates they are paying at Reid's Richmond campus."
Kinyon noted that other
insurers -- including Humana, United, Cofinity/Aetna, Encore, Health Span, HealthSCOPE
Benefits, PHCS/Multiplan, Sagamore/Cigna, Health Alliance, MD Wise, MHS, CareSource
and Corvel - have added the new locations to existing agreements.
Reid Health is reaching out to
employers with Anthem as their employee benefits insurance, asking they inform
employees they may need to choose to seek care for the affected services at
Reid Health locations in Richmond.
Services received at Reid Health Physician Associates
offices in Connersville are not affected, including at Reid Health
Primary & Specialty Care - Virginia Avenue, and Outpatient Behavioral Health
- Connersville on Park Road.
And according to Anthem's provider manual, emergency room
care should be considered as in-network, though a final determination on
coverage is up to Anthem.
Reid Health is continuing to provide services and billing
at all locations consistent with CMS regulations. The out-of-network issue does
not affect Anthem Medicare supplement plans.
Kinyon said questions about
networks and specific coverage with Anthem should be addressed directly to
Anthem. "In order to continue coverage for a market with few health care
choices, we anticipated everyone to understand the importance of avoiding any
disruptions or additional hardships on consumers. We believe Anthem could
remedy this situation quickly, especially knowing the challenges of providing
sustainable health care services to a community that has been historically hit
hard by economic challenges."
- Lab and radiology (1941 Virginia Avenue)
- Cardiopulmonary and outpatient rehab (1941 Virginia Avenue)
- Reid Health Care Pavilion (450 Erie Avenue)
- Anthem Healthy Indiana Plans (HIP)
What is NOT affected:
- Anthem Medicare supplement coverage
- Reid Health Primary & Specialty Care -- Virginia Avenue (2025 Virginia Avenue)
- Reid Health Outpatient Behavioral Health (1908 Park Road)
- Whitewater Valley Primary & Specialty Care (1473 E. State Road 44)
- Whitewater Valley Imaging (1475 E. State Road 44)
- Reid Health Urgent Care - Connersville (1475 E. State Road 44)