Managed Medicaid insurance carrier Amerigroup is canceling its contract with Grays Harbor Community Hospital effective June 28, meaning the hospital and its clinics will not be part of the insurance group’s preferred provider network. It could affect about 4,000 people in the county, hospital officials said Thursday.
The hospital is recommending that those people who want to use the health providers they’ve been using transfer their coverage for their managed Medicaid. The hospital can help people make the switch.
The hospital was told March 1 by Amerigroup “of their intention to terminate their provider partnership effective June 28 … unless the hospital was willing to take a deep cut in reimbursement,” read a statement from the hospital.
“This cancellation comes at a challenging time, and though we are hopeful for a beneficial resolution, we are preparing to help our patients move insurance carriers if they’d like to keep their providers,” said hospital spokesman Chris Majors.
The hospital is reaching out to patients about alternatives to losing their providers. “Molina also provides coverage to our community and is contracted with (our) providers,” read the hospital statement. “Beginning June 29, if you have Amerigroup Managed Medicaid but want to keep your … providers, you will need to be enrolled with Molina for Managed Medicaid coverage.”
The hospital statement said the hospital has for several months tried to negotiate a long-term contract with Amerigroup, but this month Amerigroup began calling their customers to inform them that their Grays Harbor Community Hospital and Harbor Medical Group providers were going to be out of network after June 28.
The hospital provided five options for making the switch to Molina to ease the transition.
“If somebody is pretty web savvy they can get on pretty easily, just like working with any normal website, and get the Washington Health Plan finder or Provider One and it should be relatively easy to switch,” said Majors. “People that need a little more help can get hold of a navigator.”
1. If you have internet access you can sign up at the Washington Health Plan Finder website, www.wahealthplanfinder.org
2. Contact Provider One Enrollment, weekdays 8 a.m.-5 p.m. at 800-562-3022 or online at https://www.waproviderone.org/client
3. If you don’t have internet you can call Washington Health Plan Finder or to speak with a customer service representative who will guide you through the process. Toll-free support is available 7:30 a.m. to 5:30 p.m. Monday – Friday at 1-855-923-4633; TTY: 1-855-627-9604. Language assistance and disability accommodations are provided at no cost.
4. There is also a free navigator service for Grays Harbor and Pacific counties: CHOICE Regional Health Network, 360-539-7576
5. The hospital has navigators who can help you. Call 360-532-8330 to schedule time to speak with a navigator.
While the hospital is still trying to negotiate a suitable agreement with Amerigroup, it would be wise for current Amerigroup clients to switch to Molina now to avoid potential delays in already-scheduled appointments and procedures.
“Let’s say that somebody has Amerigroup right now and they have a surgery scheduled that’s supposed to happen shortly after that date (June 28),” said Majors. “There’s supposed to be 60 days of carryover from the cancellation date for anything that’s been pre-approved (by Amerigroup), any kind of procedure or scheduled appointments, but it’s hard to say 100% that Amerigroup would choose to pay that.”
Switching earlier rather than later would also help prevent any possible delays in currently unscheduled procedures and appointments, said Majors.
“Grays Harbor Community Hospital and Harbor Medical Group would like to apologize for the burden these actions have placed on some in our community,” read the hospital statement. “These are not outcomes that we want for our community. We appreciate your patience and support as we continue discussions with Amerigroup to develop a mutually acceptable solution that benefits the health of our community.”
