Stanford Health Care and Lucile Packard Children’s Hospital in Palo Alto failed negotiations to renew their contract with Anthem, resulting in the two hospitals no longer apart of the Anthem network.
The contract expired Sept. 1, but Stanford Health has decided to honor in-network rates for Anthem members as negotiations with the health insurer continue. Anthem said in a statement, however, that it will be applying out-of-network rates to patients receiving treatment at Stanford, which does not cover as much of Stanford’s charges, leaving patients to pay the difference sometime in the future.
Stanford spokeswoman Julie Greicius said Stanford won’t bill patients the difference now and will calculate patients’ out-of-pocket expenses at the in-network rate, resulting in the patient paying the same co-pay as before the contract expired.
In 2014, contract negotiations between the two companies failed, and an agreement wasn’t found for two months. Once the new contract had been finalized, the two companies worked together to settle claims for medical services that were provided while the contract was lapsed, according to a 2014 Anthem statement.
Chris Grammar, president of Insurance by Allied Brokers in Palo Alto, says he expects the companies to come to an agreement in the coming months, according to Daily Post.
In the meantime, Anthem has advised its members to seek treatment at local hospitals that are in its network, which includes El Camino Hospital in Mountain View and Sequoia Hospital in Redwood City.
Patients who receive Medicare and Medi-cal are not affected.