Blue Cross medical plans become out-of-network at Southside Medical Center

By Zach Armstrong

(PETERSBURG, Va) -- Blue Cross and Blue Cross Blue Shield medical plans will now be considered out-of-network at Southside Regional Medical Center after Bon Secours Mercy Health and Anthem Health Plans of Virginia failed to reach an agreement after their contract ended on Dec. 1.

The Southern Virginia Regional Medical Center in Emporia and Southampton Memorial Hospital in Franklin were also affected. The move is effective immediately.

According to the Progress-Index, the move will affect around 900 municipal employees in Prince George, Hopewell and Dinwiddie (which all use Anthem medical coverage) in addition to any private businesses in the Tri-Cities area who use the health-care provider.

SRMC is the largest hospital in the Tri-Cities area. The closest BSMH Hospital that accepts Anthem in-network coverage will now be the St. Francis Medical Center in Midlothian.

According to Anthem, BSMH tried to set rates that were too high for it to reimburse while BSMH is claiming that it neither informed Anthem that it wanted to increase rates nor asked the insurer to remove hospitals from coverage during the COVID-19 pandemic.

“After purchasing these hospitals, BSMH told Anthem it wanted to increase healthcare costs at these facilities. Anthem negotiated with BSMH for the last several months to limit these price increases,” Anthem said in a statement on its website. “If we were to agree to the rates BSMH requested, healthcare costs for the Petersburg and Southside Virginia areas would rise considerably.” said Anthem.

“While we did not want to leave Anthem's network and have worked diligently to protect in-network access to the hospitals you trust, Anthem did not make any aggregate movement in proposed reimbursement rates over the entirety of this negotiation,” BSMH said in a Facebook post.

Anthem will still cover Emergency Medical Services at SRMC although an inpatient stay from an emergency room visit will still require prior authorization.