This move allows Anthem members access to hospitals with cheaper options and incentives.
SOUTH PORTLAND, Maine – Two Northern Light Health hospitals will soon offer potentially lower co-payments for many services after partnering with Anthem Blue Cross and Blue Shield to become Level 1 providers.
Northern Light Inland Hospital in Waterville and Northern Light Mercy Hospital in Portland will become Level 1 providers in Anthem’s main multi-option plans in the Maine HMO.
The move “ensures quality and affordability”, according to a joint news release from Northern Light Health and Anthem. Anthem’s multi-level HMO plans are available to members in individual, small group and large group health plans.
Issue Notes Anthem members have access to healthcare professionals and hospitals with lower costs and incentives under Anthem’s multi-level options plans in the Maine HMO.
Anthem and Northern Light Health said in a statement that by choosing a Level 1 health professional or hospital, members “can see significant savings in health care cost shares – such as lower co-payments for primary care physician and specialist visits. , lower co-insurance costs and up to $ 3,000 in savings from deductions, depending on the plan. “
With the addition of Northern Light Inland Hospital and Northern Light Mercy Hospital on July 1, 2022, all 10 Northern Light Health hospitals, as well as its health professionals, will be included at the highest level of Anthem’s multilevel options plans in Maine. HMO.
The move comes after some hospitals and medical practices in Maine announce that they will stop accepting Anthem for online coverage. Some of the problems focus on hospital systems that do not receive payments. MaineHealth, the parent company that runs Port Maine Medical Center, said its hospital system was owed about $ 70 million at one time.
Other practices report disputes under contracts with Anthem about how much the practice should charge for certain services. In May, Coastal Women’s Healthcare, the state’s largest independent obstetrics / gynecology practice, said it would give up the insurance carrier in August 2022. President Dr. Barbara Slager said Anthem pays CWH “half” of that. which other comparable practices receive. She said approximately 38 percent of CWH patients have an anthem. Sladger added that Anthem used this large leverage rate to offer low rates of return, knowing that if CWH did not renew the contract, it could probably go out of business.
Asked about the lack of payments, Susan Spruce, communications director for Northern Light Health, said in an email:
“We continue to experience some delays in out-of-state claims and Medicare Advantage, and we still meet monthly with Anthem to review unresolved issues,” Spruce wrote. Northern Light Health is happy to work with other Maine health care providers involved in this network. “
According to the office of Governor Janet Mills, Anthem is the largest insurer in Maine, covering 300,000 people. Maine staff and tens of thousands of other public service officials have an anthem for their health insurance.
“Northern Light Health is pleased to accept Anthem’s invitation to our Portland and Waterville facilities to join Tier 1 for their multi-level plans for options in the Maine HMO,” said President and CEO Timothy Dentry in a statement. “The inclusion of Northern Light Mercy Hospital and Northern Light Inland Hospital will expand access to high-quality and affordable healthcare, and we look forward to working with other Maine healthcare providers involved in this network. This will help ensure the best possible care for the people of Maine. “
“We are committed to providing access to quality, results-oriented health care, and our partnership with Northern Light Health will expand the affordable care options available to health care users in Maine in the south of the state,” said Denise McDonagh, President of Anthem Blue Cross and Blue Shield in Maine in the edition. “We know that consumers in Maine want quality, access and choice, and we are excited to continue working with Northern Light Health on our common goal of protecting the accessibility of health care for Mainers.”