Anthem Requires Contracted Providers to Notify Patients Before Making Out-of-Network Referrals January 25, 2013 News, Physician Resource Anthem Blue Cross, APN policy, Out of Network Care 0 In late November, Anthem Blue Cross announced that it would soon begin requiring contracted physicians to notify patients in writing before making out of network referrals. Effective March 1, the payor’s new “Advance Notice for Use of a Non-Participating Provider Policy” (APN policy) requires this notice be given using the payor-provided APN form. The policy does not apply to emergencies. While Blue Cross has included language in its contracts since 2008 requiring physicians to disclose to patients and document the same type of information included in the APN form, it was not often enforced. According to Blue Cross, it frequently receives complaints from patients who were unaware that they were being referred to out-of-network providers. The payor says that its new policy is not intended to deter patients from using their out-of-network benefits. Rather, it is intended to help patients make informed decisions about their coverage and options. Comments are closed.
