Patients with Anthem insurance in the Tri-State are starting to get a letter saying they may soon need to find a new doctor. Anthem and U.C. Health are having a contract dispute over money. If they don't reach an agreement soon, an estimated 14,000 patients will be affected.
Local 12's Paula Toti reached out to both sides for answers. She found patients are screaming about this on social media.
The dispute is over the amount of money U.C. Health is reimbursed by Anthem Blue Cross and Blue Shield of Ohio. Anthem says U.C. Health is already the most highly reimbursed hospital system in greater Cincinnati. U.C. Health says that's not so.
David Yungkau uses a lot of the care providers at U.C. Health and is even recovering from a recent surgery. "Vocal cord. I'm a hemophiliac ... so it's important you choose where you want to go."
Getting a letter in the mail saying he may need to find new doctors or pay out of pocket if the two sides can't reach an agreement has left him struggling for a solution. "Well you have to start a relationship with someone who hasn't known you for 20 years and it isn't fair."
U.C. Health told us the contract between the two sides was set to end March 31st but they extended it in good faith. Since then, the health care provider says Anthem has proposed a contract with rates of reimbursement below what is paid to other academic medical centers in the region. Yungkau says from what he reads on his medical bills ... the reimbursements are small. "I don't know how hospitals survive being beat up so bad. "
But Anthem told us as much as they want to provide the broadest access to health care it must be at a rate customers and members can afford. And that giving in to U.C. Health's demands is no in the best interest of customers. Yungkau is reaching out to both sides. "I sent a letter to Anthem and called and talked directly to UC."
Here's what you should know .. the contract deadline is April 15th. If there is no agreement and you have Anthem ... you can still use the U.C. Health system ... but you would pay out of network rates.
U.C. Health has urged patients to go to their Twitter and Facebook accounts ... or to speak out on Anthem's site. U.C. Health told us negotiations are continuing.
A similar situation happened a few years ago. It came down to the wire but an agreement was reached.
