Dispute between Norton Healthcare and Anthem BCBS

Hey everyone, I have been out of state all week, but I have been trying to keep a close eye on the dispute that is taking place between Norton and Anthem Blue Cross & Blue Shield of Kentucky.

According to an article I just read online from The Couier-Journal, if a deal is not reached by Tuesday (June 30), insurance provided to about 300,000 subscribers to Anthem insurance will no longer be accepted by Norton.

I am one of those subscribers...my surgery is scheduled for July 17th. I am really worried about this and I wonder what will happen if the dispute is not settled before June 30th. Is there any other hospital in Louisville that is set up for this kind of surgery? All I have heard about is Norton, Norton, Norton. I like Norton Hospital, but obviously if they will no longer accept my insurance, I am going to have a very big problem.

Does anyone have any inside information? What do  you think I can do if the dispute is not settled?

I have only read about this.  I just wanted to say.  I am sooooo sorry that you have to go through the trauma of this problem.  Surgery is such a huge decision and such a long process.  To have this worry at the end, well that is almost torture.  I will keep you and the situation in my prayers.  Please let us know if you find out anything. Hang in there.

As of Thursday, there was information that they will not come to terms by June 30th.  So what this means for you is if your policy is a EPO product, EPO products do not have out of network benefits so unless they settle this before your surgery, more than likely they will give you the option to cancel and wait and reschedule if they get the contract settled, or if you have out of network benefits then you can have the surgery but will just have a higher out of pocket cost

I have the PPO (which is a more expensive policy than the EPO) and I do believe I have out-of-network coverage....but like you said, that means that I will have to pay more out of pocket.

I am just so stressed out about this....I finally got a date and have been trying to mentally prepare myself for this and now I may have to cancel it and reschedule it. I am so upset about it. I pay all this money for my insurance and to got through the process of getting approved and now this - it's almost too much.

Do any of the other hospitals in Louisville do this surgery? I remember Dr. Geller telling me that he has privileges at Baptist. I have just have heard about bariatric surgeries being done there.

There are a few hospitals locally that actually do bariatrics.  It's just a matter of which doctor goes where and I bet you'd need to double check and be sure which doctors are providers with Anthem BC/BS as well.  Baptist East now does bariatrics, Sts. Mary and Elizabeth does them and I believe Dr. Shina has a couple places in Indiana where he does some surgeries. 

I am a red-headed step-child of Anthem too.  Luckily (or unluckily) though I am self-pay for bariatrics so I won't have to be looking for a new band doc but I will for just about everything else I and my family do medically since I've always tried to keep our medical needs under the Norton's umbrella. 

How far are you willing to travel?  I ask because my doctor, who did the surgery while still in Florence KY and is an Anthem provider, has since moved to Georgetown Community Hospital. I drive the 1 hour and 20 minutes to see him because he's an excellent surgeon with fantastic aftercare.  According to Google maps, you're about an hour and 12 minutes from Georgetown.

Just a thought.

Jan

Hmmm. I wonder if your doctor would still be in network for me. I may have to check into that. I also wonder how long it would take to get me in and scheduled for surgery.

I am going to call Anthem in the morning to see what my options are. I just hope and pray this is all settled by Tuesday.