As of March 17th, Anthem Blue Cross no longer considers Carbon Health to be an in-network provider in California. We are very sorry that Anthem's decision to not revisit the terms of our contract has caused disruption to patient care, and we'd like to provide an update.
We have been in discussions with Anthem Blue Cross since January 2022 to negotiate a livable wage and reduce the administrative burden for the services our care teams work hard to provide. With unprecedented labor shortages and increasing costs to operate our service, the rate that Anthem has paid us since 2013 is no longer tenable as a livable wage. Even a meaningful increase to our reimbursement rates would not have brought us anywhere close to what Anthem currently pays other urgent care and primary care providers in California.
Before our contract with Anthem terminated in March, we attempted to resolve our dispute multiple times with Anthem to no avail and no meaningful response. Since we went out-of-network in March, several thousands of our Anthem patients have continued to choose Carbon Health because they value and rely on the high-quality access that our clinics provide in times of urgent need. Many Anthem patients have come to Carbon Health in the last month because they are trying to avoid costly emergency room visits, despite not having Carbon Health as an in-network choice.
We followed our standard practice and submitted Anthem member claims for out-of-network processing, and Anthem has unexpectedly denied every single claim and has so far refused to reimburse us for this care. It now appears that Anthem has stopped processing thousands of claims that we have submitted on behalf of our patients. As a result, some Anthem patients have been charged out of pocket for these unreimbursed bills.
At Carbon Health, we believe everyone deserves good health – and as of today, we are taking the following steps to alleviate the burden on our Anthem patients:
We will process these steps in a timely manner for the thousands of Anthem patients who have visited Carbon Health since March 17th.
We appreciate the support from our patients who have encouraged Anthem to bring us back in-network. We will continue to submit out-of-network claims on behalf of Anthem patients who choose to come to Carbon Health for their care. We will also work diligently to come to an agreement with Anthem as soon as possible.
We encourage you to reach out to Anthem if you’d like to request that they process your Carbon Health claim or ask that they bring Carbon Health back in-network. If you have any other questions, please don’t hesitate to contact us at email@example.com