Anthem Forces NGHS Out of its Network

Published on October 01, 2019

Update:
Anthem Health Plan Participation Update – December 11 »

 


 

Published on October 01, 2019

Northeast Georgia Health System (NGHS) announced today 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.

"Despite our determined efforts to protect in-network access for patients, Anthem continues to demand terms that would negatively impact the way patients receive care at NGHS," said Steve McNeilly, vice-president of Managed Care. "We have 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 are: all Northeast Georgia Medical Center (NGMC) 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 (NGPG) locations. NGPG’s family medicine and internal medicine practices in Buford, Cumming, Dacula and Hamilton Mill are not affected by this negotiation and are still in-network.

Patients with Anthem insurance should continue to seek care with their doctors at NGHS facilities and should remember:

  • NGHS is dedicated to minimizing the financial impact of this period of disruption. For information about costs for office visits, patients should contact their provider's office, and for questions about out-of-pocket costs for a scheduled procedure or test, patients should call the NGMC Patient Access Office at 770-219-7678.
  • Patients will always have in-network access to NGMC emergency rooms. Regardless contract status with Anthem, patients experiencing an emergency should always visit the nearest emergency room.
  • Patients may have out-of-network benefits. Some health insurance plans offer out-of-network benefits, allowing continued access to NGHS. 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.
  • Speak with your employer about other options for in-network care at NGHS. Find out whether other insurance options may be available during Open Enrollment to guarantee in-network access in the next plan year.
  • Call Anthem at the number on the back of your Anthem health insurance card and explain the importance of keeping your in-network access to your trusted NGHS physicians.

For more information about the negotiation and answers to frequently asked questions, visit www.nghs.com/anthem or call the NGHS Patient Information Line at 770-691-3588.

Copyright ©2020 Northeast Georgia Health System, Inc. | 743 Spring Street Gainesville, GA 30501 | (770) 219-9000

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We want to thank our community and local businesses for their amazing generosity during this time. Here are some ways you can support our community and staff:

  • Donate items and resources

    We are currently receiving donations of items and other resources through the Foundation. Learn how to donate resources and other needed items by clicking here.

  • Sew Masks for Healthcare Workers

    Many people in our community are sewing masks for our healthcare workers. We have created some mask sewing instructions and information about drop-off locations. Get detailed mask-making instructions here.

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