By Monica Rodriguez
POMONA – More than a week after Pomona Valley Hospital Medical Center ended its contract with Anthem Blue Cross, the insurance company’s members are still calling the hospital’s help line with questions about receiving care.
And the insurance company members aren’t the only people with questions. Doctors also have questions, said hospital spokeswoman Kathy Roche.
Among those who attended a recent physicians’ meeting was Dr. Sri Gorty, a radiation oncologist with the hospital’s Robert and Beverly Lewis Family Cancer Care Center.
“Going in, I was a little bit scared,” he said this week.
Gorty, who has admitting privileges exclusively at the hospital, was concerned patients who are Anthem Blue Cross members wouldn’t be able to access services there. After the meeting Gorty felt better.
Based on the various rules the vast majority of his patients will be able to see him and receive care at the hospital, he said.
Overall, most Anthem Blue Cross members will still be able to get the services they need at the hospital until mid-December, even after the break between the hospital and the insurance company, said Roche.
More than a dozen exceptions exist that would allow patients to receive care at the hospital or through its doctors, Roche said Monday, under a plan developed by the insurance company that received approval, with some conditions, of the state Department of Managed Health care.
Anthem Blue Cross gave doctors who have admitting privileges only at Pomona Valley 120 days from Aug. 15 to secure privileges at other hospitals that do have contracts with the health insurance company. In the meantime, their patients will be covered at PVHMC.
Sixty-five percent of all the 2007 Blue Cross admissions to Pomona Valley involved doctors who had privileges exclusively at the hospital, Roche said.
monica.rodriguez
inlandnewspapers.com
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(c) 2008 San Gabriel Valley Tribune. Provided by ProQuest LLC. All rights Reserved.
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