NGHS forced out of Anthem network

Northeast Georgia Health System announced Tuesday, that, as of midnight on October 1, most NGHS facilities have been forced out of the Anthem network.

Their current contract between Anthem, formerly Blue Cross and Blue Shield of Georgia, expired with no new agreement in place.

According to Vice-President of Managed Care Steve McNeilly, NGHS offered Anthem a proposal that was rejected. He says quote “We offered Anthem a proposal that is fair to both parties, yet they refuse to work with us in a meaningful way.”

NGHS facilities currently out of network with Anthem include: all Northeast Georgia Medical Center hospitals; all rehabilitation institute, imaging center and cancer center locations; Hospice of NGMC, New Horizons Limestone and Lanier Park; Sleep Disorders Center; Laurelwood; all Urgent Care locations; all locations of The Heart Center of NGMC; and most Northeast Georgia Physicians Group locations.

In Stephens County, the Toccoa Cancer Center, the NGPG Toccoa Clinic, NGPG Pediatrics, NGPG OB/GYN in Toccoa, and NGPG Nephrology are all impacted by this change.

Patients with Anthem insurance are advised to continue to seek care with their doctors at NGHS facilities.

According to McNeilly NGHS is dedicated to minimizing the financial impact of this period of disruption.

He says regardless of the contract status with Anthem, patients experiencing an emergency will have in-network access to NGMC emergency rooms.

McNeilly does advise that some health insurance plans offer out-of-network benefits, allowing continued access to NGHS. He says patients should call the number on the back of their Anthem Health Insurance Card to find out if they qualify and what out-of-pocket costs may be.

For information about costs for office visits, McNeilly encourages patients to contact their provider’s office, and if patients have questions about out-of-pocket costs for a scheduled procedure or test they should call the NGMC Patient Access Office at 770-219-7678.

For more information regarding this change, visit nghs.com/anthem.