To: Bloomington-area Employees Enrolled in an IU-sponsored PPO Medical Plan
As reported in The Herald-Times on December 30, 2012, Premier Healthcare has yet to rejoin the Anthem PPO network. Premier wants an increase in reimbursements over the statewide fee schedule that other physicians accept. The newspaper article fails to mention who pays the cost of fee schedule increases. Employers and employees pay physicians' fees, and would also pay the cost of fee schedule increases.
Indiana University, Monroe County government, MCCSC schools, Ivy Tech, State of Indiana, Cummins, Lawrence County government, North Lawrence Schools, the City of Bedford and many others use the Anthem PPO network, and they, along with their employees, pay the cost of physician services.
For IU employees who are members of one of three medical plans—IU PPO HDHP & HSA, IU PPO $900 Deductible, or IU $400 Deductible—using an out-of-network physician means a separate deductible from the in-network deductible, higher co-insurance, and potentially out-of-network providers can bill members for charges above those that network providers accept as payment in full.
Web resources for finding in-network providers and services, including physicians, urgent care, labs, and walk-in clinic services are located at the below web page. In most cases, same day services are available for immediate needs and new patients can schedule an introductory appointment with a network provider within a couple of weeks. Visit hr.iu.edu/benefits/premier for more information and resources.
An additional resource for locating Anthem PPO network specialists has been provided by IU Health Southern Indiana Physicians. Contact Dan Rademacher, RN Care Manager at IU Health, to receive help with a referral connection to specialists in the Bloomington or Indianapolis areas. He can be reached at 812-353-3089 on weekdays from 8 a.m. – 5 p.m.
Indiana University remains hopeful that Premier will renew its contract with the Anthem PPO network in the near future. The University is concerned about the impact that provider negotiations have on medical plan members, and will look for ways that provide assistance, while providing affordable medical plan coverage.