Anthem & UC Health reach deal on new contract

Just before the contract was set to expire, Anthem and UC Health (University of Cincinnati Medical Center, UC Health Surgical Hospital, West Chester Hospital, the Drake Center, Lindner Center of Hope and all UC Health-affiliated physicians) have reached a new contract agreement.

This will allow all Anthem members to continue to seek care from their UC Health providers without paying higher amounts for a non-contracted (or Out-of-Network) provider.

Cincinnati.com article, Anthem & UC Health

Avoid Pre-Ex, Provide Prior Health Coverage

In order to prevent the hassle of an unnecessary pre-existing condition exclusion from your insurance plan, it is important complete the prior health coverage section of any insurance application. This applies to you if you are a new hire, joining the company plan for the first time, or if you are an existing employee because the company is considering a change to their policy carrier.  It is critical that you list correct information that documents ONE full year of previous insurance coverage. If you’ve had more than one coverage in the last 12 months, make sure you list that information as well.   This information includes, your prior insurance company’s name, the type of coverage you had, your prior policy number, your prior effective date, and the end date of that policy.  There will be times when the carrier will ask for a certificate of credible coverage that verifies the accuracy of the information. Most carriers will send these out after a termination is completed, but if you need one and don’t have it, you can contact the prior carrier to request it.

Anthem’s policy on Shingles Vaccine **NEW UPDATE**

As of 12/7/2012, Anthem has removed the age restriction from the Shingles vaccine. Previously only adults age 50 and up were eligible to receive coverage for this, but now, it is covered for all adults.

Hospital fees? I didn't go to a hospital...

In the recent months, we have noticed that members are receiving bills for higher amounts, following routine check-ups or laboratory services with their physicians in private practices. After taking a closer look, we can see that these patients are being billed for hospital fees due to the fact that many private practices have been bought out by larger groups that are owned by local hospitals. Examples of some of these services include x-rays, laboratory services, and scopes (endoscopy, colonoscopy). This is happening because many private practices are now billing under a facility tax id number that links to the hospital they are owned by. If this is something you are experiencing and you have questions, please feel free to contact our customer care team at 937-260-4300 or by e-mail at customerservice@mcgohanbrabender.com.