Notice for Anthem Blue Cross Blue Shield members in Virginia – applies to Bon Secours Southampton, Southside and Southern Virginia Medical Centers.
Bon Secours has been working closely with Anthem Health Plans of Virginia, Inc. (d.b.a. Anthem Blue Cross and Blue Shield (Anthem)) over the past several months to reach a new agreement. Bon Secours issued a letter of intent to negotiate to Anthem to remain in-network for Anthem’s beneficiaries. Because Anthem and Bon Secours did not reach a renegotiated contract by December 1, the current contract has terminated on that date, and affected Bon Secours facilities and services are out of network for Anthem patients.
The current contract covers the care we provide at three of our hospitals: Southern Virginia Medical Center, Southside Medical Center and Southampton Medical Center. It includes all product lines (commercial, Medicare, Medicaid, exchange). The Bon Secours Medical Group agreements remain active and are not impacted by this current hospital negotiation with Anthem.
We have worked diligently to reach an agreement with Anthem so we can continue to provide high-quality care for you and protect in-network access to the providers you trust. However, Anthem did not make any aggregate movement in proposed reimbursement rates over the entirety of this negotiation. As a result, the contracts for these three hospitals are now terminated.
Anthem patients may have Continuity of Care benefits that allow them to continue their care and receive in-network benefits after termination. To find out more about Continuity of Care benefits, please call Anthem at the toll-free number on your Anthem ID card or click on this link.
As you are a valued member of the Bon Secours family, we apologize for any concern this may cause you. Please know that Bon Secours has an unwavering commitment to serving every patient who walks through our doors with quality care.
Myth v. Fact: Bon Secours Mercy Health & Anthem Virginia Negotiations
You may have heard conflicting stories about the negotiations between Bon Secours and Anthem. We would like to set the record straight. Bon Secours is committed to maintaining contractual relationships with insurers that are fair to both parties and that put patient care first.
1. MYTH: Anthem claims Bon Secours told Anthem it wanted to remove Southside Regional Medical Center, Southampton Memorial Hospital and Southern Virginia Regional Medical Center from Anthem’s network on December 1, 2020.
FACT: Bon Secours’ first priority is our patients and their well-being. Bon Secours issued Anthem a letter of intent to renegotiate our current contract for the care we provide to its members—our patients. Our negotiation priorities included making contract language consistent across all our hospitals and adjusting rates for these three hospitals which are significantly below market. We committed in that letter to meeting with Anthem weekly to finalize negotiations. The termination notice was to be effective only in the event the parties failed to reach agreement. In order to be resilient for our patients and communities, we need fair contracts with payers, like Anthem. Our health care team works tirelessly every day, through every challenge, to fulfill our responsibility. But in our opinion Anthem is falling short of its responsibility by paying these three providers less than competitive rates and expecting patients to shoulder the difference.
2. MYTH: Anthem said Bon Secours told Anthem it wanted to increase costs at Southside Regional Medical Center, Southampton Memorial Hospital and Southern Virginia Regional Medical Center after buying them.
FACT: Contract negotiations between hospitals and health plans are critical to maintaining necessary resources and access to top-quality care for patients. Bon Secours needs fair contracts that protect our ability to continue to provide state of the art care. Bon Secours requested an increase to our reimbursement rates from Anthem, which is consistent with standard industry practice, to ensure our facilities remain a viable resource to the communities we serve for many years to come. It’s important to note that the costs we incur to provide the necessary labor, supplies, and pharmaceuticals, to name just some of our costs, continue to increase. In addition, the pandemic has placed significant pressure on hospital finances and the need to negotiate competitive rates.
3. MYTH: Anthem claims it has negotiated with Bon Secours for the last several months to limit price increases. Anthem said it understands how important these hospitals are to the residents of Southern Virginia, and that Anthem continues to work toward a new contract that will keep Bon Secours in Anthem’s network.
FACT: Simply put, we do not believe Anthem has been a good partner and we do not believe that Anthem has worked or continues to work in good faith toward a new contract to keep these three Bon Secours hospitals in network. After 90 days of trying to engage Anthem in meaningful conversations, the large, for-profit corporation made little to no movement on the issues critical to a continuing relationship. Anthem has not engaged in any negotiation discussions with Bon Secours since November 30, 2020. We remain open to further negotiations to bring these three Bon Secours hospitals back in network. Anthem also has not been paying current member claims in a timely fashion to the entire Bon Secours Mercy Health ministry—resulting in millions in unpaid claims. Finally, Anthem will no longer honor the patient’s assignment of benefits, by which patients direct payment from Anthem to these three Bon Secours hospitals, which we believe will create confusion and significantly delay payment to these hospitals. We believe that Anthem’s actions are not suggestive of either good-faith negotiations or a valued partnership. Now, because of their own unwillingness to work with us, Anthem is the only major insurer in the market who does not have an agreement with these three Bon Secours hospitals.
Frequently Asked Questions
Why has Bon Secours gone out of network with Anthem insurance?
We began good faith efforts to reach a new and equitable contract with Anthem.
Our goal is simply to make the needed contract adjustments that will enable Bon Secours to continue providing care for our community for many years to come.
Did Bon Secours inform Anthem that it wanted to remove Southern Virginia Medical Center, Southside Medical Center and Southampton Medical Center from Anthem’s plans’ networks during a pandemic?
No. Bon Secours issued a letter of intent to negotiate to Anthem in order to remain in Anthem’s network. Anthem’s current reimbursement to these hospitals is not sustainable or market competitive.
Did Bon Secours inform Anthem that it wanted to increase costs at these hospitals?
No. Bon Secours issued a letter of intent to renegotiate rates because the current reimbursement to these hospitals are not market competitive and are not sustainable.
What does that mean for me as a current Bon Secours patient with Anthem insurance?
The affected Bon Secours hospitals (Southern Virginia Medical Center, Southside Medical Center and Southampton Medical Center) are no longer in-network providers with Anthem insurance. Here are three options you could choose to take:
1. Depending on your situation, you may have Continuity of Care benefits that allow you to continue your care and receive in-network benefits after termination. This might include services for patients that are in an active course of treatment, pregnancy services (for patients who have entered the second or third trimester of pregnancy) continued through the provision of postpartum care directly related to delivery, or continued services for patients determined to be terminally ill. To find out more about Continuity of Care benefits, please call Anthem at the toll-free number on your Anthem ID card or click on this link for the application form. You will need to apply for these benefits with Anthem within 30 days from December 1, 2020.
2. If you choose to continue receiving care with us, be aware that accessing care from out-of-network providers may increase your out-of-pocket costs. Depending on your health plan, you may have out-of-network benefits. Our financial advisors are ready to help you find a solution, just call 877-342-1500.
3. You can also visit another Bon Secours hospital that is in network with Anthem. These include:
St. Mary's Hospital (Richmond)
Memorial Regional Medical Center (Richmond)
St. Francis Medical Center (Richmond)
Richmond Community Hospital (Richmond)
Rappahannock General Hospital (Richmond)
Bon Secours Maryview Medical Center (Hampton Roads)
Bon Secours Depaul Medical Center (Hampton Roads)
Bon Secours Mary Immaculate Hospital (Hampton Roads)
What can I do?
If you are currently receiving care at an affected Bon Secours facility for an ongoing medical issue, you may have Continuity of Care benefits that allow you to continue your care and receive in-network benefits after termination. To find out more about Continuity of Care benefits, please call Anthem at the toll-free number on your Anthem ID card or click on this link.
If you are a patient and you have the opportunity to elect another health plan, we encourage you to consider choosing one that is in-network with these Bon Secours hospitals. Bon Secours is contracted with all other major health insurance companies.
If you would like to be part of the conversation, you can contact your insurance company, Anthem, and let them know that you get medical care at one of these Bon Secours facilities and would like to continue to receive services there. You can also contact your employer’s benefit department and inform them you would like to continue to use Bon Secours hospitals and encourage them to call Anthem.
Would you like to contact a Medicare Insurance Helpline? Bon Secours has partnered with MedicareCompareUSA to offer free, personalized assistance to patients during the Medicare Annual Enrollment Period and throughout the year. Through the Helpline, you can compare and enroll in Medicare plans accepted by Bon Secours including Medicare Advantage, Medicare Supplement and Medicare Prescription plans. The Helpline is staffed Monday-Friday and can be reached by calling 855-608-4783. (MedicareCompareUSA is an independent insurance agency not affiliated with the federal Medicare program. All services are provided at no cost. MedicareCompareUSA and affiliated agents are paid directly by the Medicare plan you choose.)
What if I need to go to an emergency room?
You will continue to have access to all Bon Secours hospitals in cases of emergency treatment, regardless of the network status with Anthem. If you experience an emergency, please seek treatment at the nearest emergency center or call 911.
Who can I talk to if I have questions?
If you have questions about your Anthem coverage, please call them using the number on your insurance card.