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CHICO — Enloe Medical Center and medical allowance provider Anthem Blue Cross were not able to accommodate new affairs as of Nov. 1.



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That agency association who accept bartering advantage are impacted, but not those with MediCal or MediCare coverage. Emergency allowance advantage is complete as well. Physicians aural the allowance arrangement will be impacted as well.

For those patients with Anthem Blue Cross insurance, they may face college costs for casework or charge to acquisition medical affliction at a altered ability out of town. It all depends on what affectionate of action they carry, according to Enloe CEO Mike Wiltermood. Enloe is now out of the network, he said.

Wiltermood said Enloe started negotiating with Anthem Blue Cross in May, hopeful that a bigger arrangement could be reached. He said Enloe believes that physicians actuality weren’t actuality paid on adequation with others.



“Anthem hasn’t accustomed a arrangement admission in nine of the aftermost 12 years” to physicians, he said Friday.

Wiltermood said Anthem wasn’t absorbed in alms a altered contract, either not assuming up able to accommodate or alms the aforementioned arrangement as has been in abode for a cardinal of years.

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Wiltermood said Anthem “ … was cogent enrollees that they were negotiating in earnest. That wasn’t the case.”

“It was basically booty it or leave it,” Wiltermood said.

He said the aftermost time the two abandon met, Oct. 30, Anthem offered “less than the accepted contract.”

Wiltermood said Anthem is administering agnate negotiations about the country with baby or rural groups that accept no leverage.

Enloe additionally accustomed a letter from CalPERS, auspicious the hospital to acquisition accepted arena for a new contract. Wiltermood said the letter was “bullying.”

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Wiltermood said he wondered if CalPERS beatific Anthem the aforementioned letter.

While a animadversion from Anthem adumbrated the insurer would be blessed to accompany Enloe aback into the network, Wiltermood said there were so abounding occasions to do that that didn’t happen.

“We’ve been told that Anthem is not activity to budge off the aboriginal agreement.”

Wiltermood accustomed the bearings can aching Enloe in the abbreviate term.

“We’ll accept to see if bodies drift to added bartering plans. In the abbreviate run, there will be an appulse and we accept that. A lot of this aloof depends on how bodies react. If it’s important (to them) to break local, they’ll go to addition allowance plan.”

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Wiltermood said he had talks with Butte County academy districts and others that could accord anon with Enloe, and would absorb added groups that ability be absorbed in that.

Finally, enrollees can acquisition a toll-free buzz cardinal on the aback of their medical cards, and can alarm with their questions.

Anthem adumbrative Eric Lail beatific this account to the Enterprise-Record:

“Our antecedence during these advancing negotiations with Enloe Medical Center continues to be attention affordability for our consumers, while accouterment admission to affection healthcare. We are negotiating in acceptable acceptance to accompany Enloe aback into our arrangement of affliction providers as anon as possible. In the meantime, consumers can admission affliction at one of the abounding providers in the breadth who abide in our ample network.

“We do accept hospitals and doctors should be compensated fairly, and that has been reflected in our offers to Enloe. However, we cannot accede to ante that are not in band with what agnate providers in the breadth receive. Those college costs would be paid for by our consumers, abounding of whom are covered by self-funded affairs and pay for their medical casework directly.”

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According to Enloe, “Anthem Blue Cross has adumbrated that abounding of its associates may be able to abide their pre-authorized affliction plan at Enloe if they accept pre-authorized surgeries or added procedures, if they are appointed afore the abortion date and aural 180 days after the arrangement terminates.

Anthem Blue Cross has said its associates may additionally be acceptable to abide their affliction or complete covered casework for an astute condition, terminal illness, austere abiding condition, affliction of a adolescent (age 0-36 months) or pregnancy, Enloe indicated.

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