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Augusta Health Patients with Anthem Insurance Face Possible High Expenses

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AUGUSTA COUNTY, Va. (WVIR) -

Thousands of Augusta Health patients covered by Anthem insurance plans are facing possible big out-of-pocket expenses to continue their care at the hospital.

These potential changes are because of an ongoing contract dispute over how much the insurance company pays the hospital for services.

Augusta Health is asking Anthem for a 7.5 percent annual increase in its rates.

The Fishersville hospital says Anthem is low-balling them, compared to the increases it offers other health systems.

Augusta Health's Anthem Member Assistance Center is taking phone calls and emails and meeting with patients in-person to help them understand their benefits.

The hospital is considered "out-of-network" since the contract with Anthem ended Sunday.

The center has helped as many as 140 patients a day.

Counselors can explain benefits, offer financial assistance, and fill out continuation of care forms - which allow Anthem customers to keep seeing their doctors at Augusta Health for a limited time.

“Just because it's out of network doesn't mean you don't have choices,” says Scott Crabtree, Augusta Health Administrative director of professional services. “We've found that many patients can still come here, keep their physician, keep their healthcare provider here at Augusta Health, and not have the financial burden placed on them that they were anticipating.”

The center is open in the Augusta Health business office from 9 a.m. to 6 p.m.

Counselors say it can take more than an hour to fill out all the paperwork, so prepare to take the time.

It will remain open as long as the contract dispute continues.

A hospital spokeswoman says the last negotiation with Anthem happened Sunday night, just before the contract expired.

In a statement to NBC29, Anthem says it "will continue an open dialog with the goal of reaching an agreement that will bring Augusta Health back into our network.”

Statement from Anthem Insurance on Augusta Health:

For Anthem Blue Cross and Blue Shield our members are our number one priority, and we are committed to limiting any disruptions that may be caused by the current situation with Augusta Health. As we have done for the past several months, we will continue an open dialog with the goal of reaching an agreement that will bring Augusta Health back into our network.

We have dedicated customer service teams standing by ready to support members who need help finding one of the many other high-quality health care providers in the area.

Importantly, we want to remind our members that doctors within Augusta Medical Group remain in our network through January 31, and it is our hope to have a new contract in place by then; and emergency care is always a covered benefit — anyone with a medical emergency should always call 911 or go to the nearest emergency department.

Members can call us by using the toll-free member services number located on the back of their Anthem Blue Cross and Blue Shield card, or they can visit Anthem.com and use the menu list to search for a list of providers in the area.