Anthem Blue Cross Notifies Physicians of Intent to Terminate Medicare Advantage PPO Contracts August 2, 2013 Medicare, Payment Medicare, Medicare Advantage, Anthem Blue Cross 0 On July 25, Anthem Blue Cross notified 973 practices advising of its intent to terminate the practices’ Medicare Advantage PPO contract. According to the notice, Blue Cross has decided to narrow this network of providers and is exercising its right to terminate the agreement without cause, per the terms of the contract. Two different notices were issued to practices. The first went to 881 practices who, according to Blue Cross, had a low volume of claims billed to Blue Cross. The other went to 92 practices who, Blue Cross reports, had a higher cost of care relative to other network providers. The termination becomes effective on January 31, 2014. Physicians whose contracts are terminated can, however, continue to see Blue Cross Medicare Advantage patients on an out-of-network basis and be reimbursed by Blue Cross at Medicare rates. Physicians are reminded that out-of-network services typically result in higher out-of-pocket costs for patients. Practices are encouraged to discuss their network status with patients in advance. Practices who wish to appeal the termination may do so by sending written notice and supporting documentation to: Anthem Blue Cross P.O. Box 292187 Nashville, TN 37229 Questions can be directed to Blue Cross Network Relations at (855) 238-0095 or networkrelations@wellpoint.com. Comments are closed.
