Anthem Healthkeepers POS Subscriber:
We want to take this opportunity to inform you of very important Emergency Room provider participation information related to the Anthem Healthkeepers POS network.
Human Resources was just notified that the Emergency Room physicians staffing the Fauquier Hospital ER are not currently HealthKeepers participating providers. Keep in mind, the Fauquier Hospital is an in-network facility, and it is only the ER physicians that are considered HealthKeepers out-of-network providers. This ER physician group is a KeyCare PPO participating provider.
If you seek emergency medical care at Fauquier Hospital’s Emergency Room, Anthem will process your ER related claims at the in-network level, to include the ER physician charges. However, in addition to receiving an Explanation of Benefits, since the Emergency Room physician(s) are not in-network providers, you will personally be issued a check representing Anthem’s payment for the ER physician(s) charges. The ER physician may bill you the difference between Anthem’s payment and their total charges.
Therefore, unless a life threatening emergency, you are encouraged to access Emergency Room services at alternative hospitals, Urgent Care or Retail Health Clinic. You may also call the Anthem 24/7 Nurse Line at 800 337-4770 for advice related to whether or not an emergency room is the most appropriate setting for your medical care.
Please take the time to familiarize yourself with alternative options through Anthem’s Find A Doctor website. Currently all Emergency Room physicians at other local hospitals are HealthKeepers participating providers; this ER physician group is one of the few exceptions throughout the Commonwealth.
We are regularly in touch with Anthem and want to assure you that their provider relations staff always attempts to secure a provider contract with the ER physicians that staff participating facilities, and they continue to work toward securing a HealthKeepers participating provider contract with the Fauquier Hospital ER Physicians’ group. We will keep you updated as we receive additional information.