The move gives 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 following a partnership with Anthem Blue Cross and Blue Shield to become Tier 1 providers.
Northern Light Inland Hospital in Waterville and Northern Light Mercy Hospital in Portland will become first-tier service providers in Anthem’s Maine HMO option plans.
The move “ensures quality and accessibility”, according to a joint press release from Northern Light Health and Anthem. Anthem’s HMO Maine Multiple Options Plans are available to members in individual, small group, and large group health plans.
The statement states that members of Anthem have access to health workers and hospitals with cheaper options and incentives according to Anthem’s plans for multiple options for HMO in the state of Maine.
Anthem and Northern Light Health said in a statement that by choosing a Level 1 health care provider or hospital, members “could see significant savings in health care costs - such as lower co-payments for visits to primary care physicians and specialist clinics, lower co-insurance costs and up to $ 3,000 in savings, depending on the plan. “
With the addition of Northern Light Inland Hospital and Northern Light Merci Hospital on July 1, 2022, all 10 Northern Light Health hospitals, as well as its healthcare professionals, will be included in the top level for Anthem’s plans for multiple HMO options in the state. Maine.
The move comes after some hospitals and medical facilities in Maine announce that they will stop accepting Anthem for online coverage. Some of the problems are related to hospital systems that do not receive payments. MaineHealth, the parent company that manages the Maine Medical Center in Portland, said that its hospital system was owed about 70 million dollars at one time.
Other practices report disputes over contracts with Anthem over how much the practice should charge for certain services. In May, Coastal Women’s Healthcare, the state’s largest independent gynecology practice, announced it would drop insurance in August 2022. President Dr Barbara Slager said Anthem pays CVH “half” of what other similar practices have received. She said that approximately 38 percent of patients with CVH have an anthem. Slager added that Anthem used that large percentage as leverage to offer low rates of compensation, knowing that if CVH did not renew the contract, it could fail.
Asked about the lack of payments, Suzanne Spruce, communications director for Northern Light Health, said in an email:
“We still have some delays with claims outside the state and Medicare Advantage, and we still meet once a month with Anthem to review unresolved issues,” Spruce wrote. Northern Light Health is happy to work with other Maine health professionals who participate in this network. “
According to the office of Governor Janet Mills, Anthem is the largest insurer in Maine, covering 300,000 people. Employees in the state of Maine and tens of thousands of other employees in public services have an anthem for their health insurance.
“Northern Light Health is pleased to accept Anthem’s invitation to our facilities in Portland and Waterville to join Tier 1 for their Maine HMO option plans,” said President and CEO Timothy Dentry in a statement. “The inclusion of Northern Light Merci Hospital and Northern Light Inland Hospital will expand access to high-quality, affordable healthcare, and we are thrilled to be working with other Maine healthcare professionals participating in this network. This will help provide the best possible care for the people of Maine. “
“We are committed to providing access to quality outcome-based health care, and our partnership with Northern Light Health will expand the affordable care options available to Maine healthcare consumers in the south,” said Denise McDonough, president of Anthem Blue Cross and Blue Shield. in Maine in edition. “We know that Maine consumers 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.”