Shared from the 8/15/2017 The Virginian-Pilot eEdition

Women’s care centers plan to drop Anthem as in-network insurer in area

the change

Starting Nov. 1, patients at more than two dozen Mid-Atlantic Women’s Care centers won’t be considered in-network for Anthem. Patients can continue care with the practices as out-of-network providers, but it likely will cost them more.

affected centers

Practices under the company that will be affected by the decision not to cover Anthem patients in-network:

Chesapeake Women’s Care, Chesapeake

Gynecology Specialists, Chesapeake

Mid-Atlantic Imaging Center, Chesapeake

Synergy: An Integrative Medicine Center for Women, Chesapeake

The Group for Women, Chesapeake

TotalCare for Women, Chesapeake

Virginia Center for Women, Chesapeake

OB-GYN Physicians, Franklin

Center for Women’s Health, Hampton

Hampton Roads Obstetrics & Gynecology, Hampton

Obstetrics and Gynecology Associates of Hampton, Hampton

Center for Women’s Health, Newport News

Mid-Atlantic Imaging Center, Newport News

Obstetrics and Gynecology Associates of Hampton, Newport News

Peninsula Women’s Care, Newport News

Virginia Center for Women, Nags Head, N.C.

Mid-Atlantic Imaging Center, Norfolk

The Group for Women, Norfolk

Tidewater Physicians for Women, Norfolk

WomanCare Centers, Norfolk

Women Caring, Norfolk

Specialists for Women, Suffolk

Complete Women’s Care, Virginia Beach

Mid-Atlantic Imaging Center, Virginia Beach

New Hope Center for Reproductive Medicine, Virginia Beach

Tidewater Physicians for Women, Virginia Beach

TotalCare for Women, Virginia Beach

Virginia Beach Obstetrics & Gynecology, Virginia Beach

Women’s Health Choice, Virginia Beach

Anthem-insured patients at more than two dozen women’s care centers across Hampton Roads will no longer be covered in-network starting in a few months, Mid-Atlantic Women’s Care announced Monday.

“For over 2 years we have attempted to reach a mutually acceptable agreement with Anthem to continue to provide care as in-network providers,” Mid-Atlantic officials wrote in a notice to patients. “Unfortunately, we cannot continue under Anthem’s terms and conditions. This is a decision we did not take lightly.”

The company oversees 29 practices from Franklin to Nags Head, including seven in Chesapeake, five in Norfolk and seven in Virginia Beach.

The change takes effect Nov. 1, Mid-Atlantic said, and means affected patients could end up paying more.

But Anthem spokesman Scott Golden said the insurer hopes to reach an agreement with Mid-Atlantic before November. “Hopefully we can come together,” he said.

In general, such negotiations center around reimbursements, Golden said.

“The physician group doesn’t feel they’re being reimbursed enough. That’s normally the sticking point.”

Last week, Anthem announced it will stop offering individual health insurance plans under the Affordable Care Act next year in Virginia, citing in part the uncertainty in Washington over the health care law.

Robert Sterling, Mid-Atlantic’s executive director, declined to elaborate on issues with Anthem, saying contract negotiations are private. He said Anthem patients can continue care with the practices – as out-of-network providers.

Wendy Stedman, 44, a secretary and bookkeeper with Chesapeake Public Schools, is a patient at WomanCare Centers in Norfolk and said her deductible is $3,000.

“I’d have to pay for it all out of pocket,” she said. “I’m not sure what I can do.”

She said she’s been with her doctor for more than 20 years and is “now faced with having to find a new one. ... I love my provider.”

She said her provider’s been with her through her health issues as well as prenatal, delivery and postnatal care of her daughter.

Mid-Atlantic Women’s Care says on its website that it is “the premier OB/ GYN group in Hampton Roads” and was created two decades ago through the merger of 11 independent physician groups. More than 70 doctors serve in the company. Sterling declined to provide a total number of women served.

Pregnant women in their second or third trimester by Oct. 31 will “continue to receive care as if we were in-network providers through their delivery,” Sterling said in an email.

Company officials said current patients should ask their employers about alternative health plans that allow coverage at Mid-Atlantic. Sterling added that patients should ask Anthem about out-of-network benefits before getting care.

Stedman said she was supposed to go to her OB-GYN in July but has been too busy.

“I’ll have to get around to it now,” she said. “Where are we all supposed to go now?”

She added that OB-GYNs are “not the type of doctors women feel comfortable in going to anyway, let alone being forced to find new ones because of insurance squabbles.”

The Associated Press contributed to this report.

Katherine Hafner,

757-222-5208, katherine. hafner@pilotonline.com.

Follow @khafner15 on Twitter.

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