Anthem Blue Cross and Blue Shield and Schumacher Clinical Partners review network agreements as two hospital-based, physician groups leave our networks
August 21, 2018
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Recently, we received notification that Roanoke Physician Services LLC (an emergency medicine physicians’ group) and Commonwealth Hospitalist Group LLC (a physicians’ group focusing primarily on the comprehensive medical care of hospitalized patients) are no longer in operation and ceased providing emergency medicine and comprehensive medical care services at Lewis Gale facilities in southwest Virginia. As a result, Roanoke Physician Services and Commonwealth Hospitalist Group no longer participate in our provider networks effective July 3, 2018. The Lewis Gale locations are Salem [hospital medical center and free-standing emergency room (ER)], Montgomery, Pulaski and Alleghany.Schumacher Clinical Partners now owns and manages the ER and hospitalist groups serving Lewis Gale facilitiesAnthem Blue Cross and Blue Shield and our affiliate HealthKeepers, Inc. did not receive sufficient advance notice of such changes in operations. Once we learned of the change in operations for Roanoke Physician Services and Commonwealth Hospitalist Group, we began aggressively working with Schumacher Clinical Partners – the contracting firm of the new physicians’ groups serving the area. While we have been in contract talks with Schumacher Clinical Partners to obtain network participation agreements, we have been unsuccessful in reaching an agreement with the contracting firm to date. Schumacher Clinical Partners owns and manages the following ER and hospitalist groups which are the exclusive emergency medicine and hospitalist providers serving the Lewis Gale facilities effective July 3:ER Groups managed by SchumacherHospitalist Groups managed by SchumacherMill Mountain Emergency Group, LLCIngleside Physician Services, LLCIngleside Emergency Group, LLCWildwood Physician Services, LLCWildwood Emergency Group, LLCKingsford Physician Services, LLCKingsford Emergency Group, LLCLake Spring Physician Services, LLCLake Spring Emergency Group, LLCThe ER and hospitalist groups in the preceding table remain out-of-network providers for our professional provider networks for our following health plans:
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Anthem’s PAR/PPO health plans including the Blue Cross and Blue Shield Service Benefit Plan (also called the Federal Employee Program® or FEP)
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Anthem HealthKeepers plans including health plans purchased on or off the Health Insurance Marketplace
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Anthem HealthKeepers Plus (Medicaid/FAMIS and the Commonwealth Coordinated Care Plus plans)
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Medicare Advantage health plans
Please note that this notification ONLY applies to physician groups owned and managed by Schumacher Clinical Partners. All Lewis Gale hospital locations remain network participating facilities. The hospitals and all other hospital-based service providers at Lewis Gale locations remain part of our Anthem PAR/PPO and Anthem HealthKeepers networks.We remain in negotiations with Schumacher Clinical Partners and are hopeful that we can come to an agreement to have the physicians’ groups managed by the contracting firm to join our comprehensive network of participating physicians’ groups.Anthem and HealthKeepers, Inc. continue to work collaboratively with physicians, hospitals, ancillary providers and other health care professionals to help ensure our members have uninterrupted access to dependable, high-quality health care at an affordable price through a broad and comprehensive provider network. Anthem and HealthKeepers, Inc. attempt to negotiate reasonable fees for services that physicians and other health care professionals and facilities provide as part of our network contracts with these providers. In fact, keeping health care costs fair for everyone is one of our main responsibilities.Frequently Asked Questions
Here, we’ve included a list of Frequently Asked Questions (FAQs) along with responses regarding the changes in network participation for Schumacher Clinical Partners. In addition, we’ve included a list of alternate providers at the end of the FAQs. We will continue to revise the FAQs as needed , so please refer to this page often for updates as they become available.Notices to Employers and Brokers
Anthem Blue Cross and Blue Shield and Schumacher Clinical Partners review network agreements as two hospital-based physicians’ groups leave our networks. -
