Sonoma Valley Hospital may be excluded from the Anthem Blue Cross network beginning February 1, 2024
Updated December 7, 2023: Our hospital continues to negotiate with Anthem Blue Cross. We are focused on insuring that the reimbursement provided by the insurance company meets the cost the hospital spends to provide care to Anthem members. This cost includes wages, supplies, overhead (water, electricity, etc.) as well as a tiny fraction of the money we will need to reinvest in our building to insure we continue to have the tools necessary to provide care. This is the expectation we have for all of our insurance partners.
While we wish we could tell you when this will end, we are prioritizing the financial viability of our hospital and insisting that our insurance partners provide reasonable reimbursement. Contact us at community@sonomavalleyhospital.org with any questions.
The Facts
Sonoma Valley Hospital may be excluded from the Anthem Blue Cross network effective February 1, 2024. SVH has been in negotiations since June of this year.
We continue to negotiate an agreement with Anthem Blue Cross that would allow us to provide in-network care to Anthem Blue Cross members at Sonoma Valley Hospital. Unfortunately, Anthem Blue Cross has not accepted our proposals and our current contract is set to expire on February 1, 2024.
SVH and Anthem Blue Cross FAQConsider Switching Plans
If coverage at SVH is important to you, please explore other plans that include SVH in their network. You may have the option to switch your coverage during your employer’s Open Enrollment. A list of plans we participate in are below:
HMO
Meritage Medical Network (ALL HMO’s offering Meritage for their medical group)
PPO
Aetna
Blue Shield of California, PPO
Cigna
Community Health Plan (CHP)
First Health
Health Net
Health Smart/InterPlan
Humana Choice Care
Multiplan
Pacific Health Alliance (PHA)
Private Healthcare Systems, Inc. (PHCS)
TRPN – Three Rivers Provider Network
United Healthcare
Western Growers – Pinnacle Claims Management
Putting Patients First
For nearly 80 years, our community has relied on SVH to keep them and their families healthy. Every day we are hard at work to make care more accessible and affordable for everyone we serve.
Yet, we face serious challenges. Healthcare providers across the country are experiencing the crushing weight of rapidly rising costs of care caused by inflation, labor shortages and reductions in funding.
Sonoma Valley Hospital is no exception.
To continue to serve as a reliable source for quality, convenient care, we need sustainable reimbursement from Anthem Blue Cross, the state’s largest health insurance company.
We know you may have questions or concerns about how our network status may impact your access to care with SVH. We’re here to help our community, whenever and wherever they need us.
For more information, please check our frequently asked questions (FAQ), or email us at community@sonomavalleyhospital.org. You may also call the Department of Managed Health Care (DMHC), which protects consumers, by telephone at its toll-free number, 1-888-HMO-2219, or at a TDD number for the hearing impaired at 1-877-688-9891, or online at www.hmohelp.ca.gov.
What You Can Do
You can advocate for your continued in-network access to Sonoma Valley Hospital.
Call Anthem Blue Cross
Using the number on the back of your insurance card, let Anthem Blue Cross know how vital it is to have in-network access to Sonoma Valley Hospital.
If you receive your insurance through your employer
Ask your HR or benefits manager about alternate or secondary coverage options that will protect your in-network access to Sonoma Valley Hospital.
If you buy insurance from the Health Insurance Exchange
Open Enrollment period starts November 1, 2023, and runs through January 14, 2024. To guarantee your continued in-network access to SVH, consider selecting a plan during Open Enrollment that includes SVH in its network.
Contact Us Anytime
Have Questions? Email us anytime.
We know you may have questions or concerns about how our network status may impact your access to care. We’re here to help.
Please email Lisa Stone (community@sonomavalleyhospital.org) anytime with questions.
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