Hendricks Regional Health's Brownsburg (Ind.) Hospital, a six-bed facility, said Anthem will not cover certain services at the facility because the insurer deems it a microhospital, according to a WFYI Indianapolis report.
As a result, the hospital began billing some Anthem members in full for cardiac testing, radiology services, mammography, rehabilitation services and any inpatient care June 1. Physician office visits, laboratory services and immediate care center services are still considered in network for Anthem policyholders.
"We held claims as long as we could, but Anthem forced our hand," Brownsburg Hospital said. The hospital's Chief Strategy Officer Gary Everling told WFYI Indianapolis contrary to what Anthem said, the facility is not a microhospital and should be reimbursed the same as other Hendricks Regional Health hospitals.
"They won't reimburse Brownsburg hospital with the same rates for the same services we provide in their contract in Plainfield, Avon or Danville," Mr. Everling said.
In a statement to WFYI Indianapolis, Anthem, which has never had a contract with the Brownsburg hospital, noted it only has six inpatient beds and no surgical capabilities.
The dispute comes after St. Louis-based Ascension subsidiary St. Vincent, located in Indianapolis, signed an in-network arrangement with Anthem for its microhospitals in Indiana.
Editor's note: This article was updated June 28 at 9:39 a.m. CT to reflect Anthem has never contracted with Hendricks Regional Health's Brownsburg Hospital. A previous version misstated this fact. We regret this error.
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