Another contract dispute for Anthem

Clark County

Discussion

December 16, 2009

Health insurer trying to reach a deal with Radiology Associates

By BRADEN LAMMERS The News and Tribune Wed Dec 16, 2009, 12:38 PM EST

A notice of the cancellation of health coverage provided by Anthem Blue Cross and Blue Shield related to a local radiological services company is incorrect, for now, according to the parties involved.

A notice sent to individuals enrolled under the Anthem’s Federal Employee Program’s standard or basic option coverage said they will no longer receive in-network benefits when getting services performed by Radiology Associates Inc, a Jeffersonville-based company with an additional office location in New Albany.

The hospital-based radiology group provides services at several locations throughout Southern Indiana, including Clark Memorial Hospital, Floyd Memorial Hospital and Health Services, Harrison County Hospital and Kindred Hospital.

However, the statement of cancellation sent out to people within the network is incorrect, as it stated Anthem would no longer be contracting with Radiology Associates as of Dec. 15.

“We are under contract as of this point,” said LaTonya Brown, office manager for Radiology Associates.

Tony Felts, communications director with Anthem, agreed.

“They [Radiology Associates] are currently in Anthem’s network,” he said.

But what is unclear is when the contract will end if the two sides are unable to reach a deal.

Brown said that the company is in negotiations with Anthem to work out a contract, but declined to give any details, except that the current deal is set to expire Dec. 31.

Felts believes the contract is set to expire Dec. 25, but also reiterated the parties are working on establishing a new contract.

“At this point, we are hoping we can get an agreement in place before the end of the year,” Brown said.

If a deal is not reached before the end of the year, it is likely that those covered by this specific Anthem federal plan will be charged out-of-network rates for services.

“If that does not occur, then this radiology group would be outside Anthem’s network” Felts said.

Radiology Associates is the only company providing radiological services at Clark Memorial Hospital.

But the impact on the patient, as far as cost are concerned, would not be exorbitant, according to Mary Jennings, director of marketing and public relations for Clark Memorial Hospital.

Typically, the only costs passed onto the patient are the costs for reading the scan, not the cost for the scan itself, Jennings said.