Anthem forces Northeast Georgia Health System out of its Network

Northeast Georgia Health System (NGHS) announces 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 of 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.  NGHS is a non-profit on a mission of improving the health of our community in all we do. Our team cares for more than 1 million people across the region through four hospitals and a variety of outpatient locations. Northeast Georgia Medical Center (NGMC) has campuses in Gainesville, Braselton, Winder and Dahlonega – with a total of more than 700 beds and more than 1,100 medical staff members representing more than 50 specialties. Learn more at www.nghs.com.