Anthem and CommonSpirit Health tied up in negotiations

For Coloradans caught in the middle; the Anthem Blue Cross Blue Shield, and CommonSpirit Health issue is leaving consumers with questions.
Unsuccessful Negotiations

As of May 1, 2024,  Anthem and CommonSpirit Health Plans have not had success with coming to an agreement on terms. This means there is not a contract between these organizations, and facilities and physicians associated with CommonSpirit are not currently part of Anthem’s commercial, Medicare Advantage, or self-insured health plans.

Following is a Press Release from the Colorado Department of Regulatory Agencies describing in detail the current situation. There are links included to help with consumers questions.

Have questions, or need some help finding the right coverage?  Contact HomeTown for a free quote.

Commissioner Calls on Anthem and CommonSpirit to Continue Negotiating to Reach a Deal for Colorado Consumers

As of May 1, CommonSpirit Health facilities and physicians are no longer part of Anthem’s network in Colorado.

DENVER – The health insurer Anthem Blue Cross and Blue Shield and the health care system CommonSpirit Health have been unable to agree to a new contract that would allow CommonSpirit Health facilities to continue to be part of the Anthem provider network. As of today, May 1, there is no longer a contract between these two entities, and CommonSpirit facilities and its physicians in Colorado are no longer part of Anthem’s commercial, Medicare Advantage, and self-insured health plans. However, it is the DOI’s understanding that the parties continue to negotiate to try to reach an agreement to bring CommonSpirit Health in-network.

“We urge Anthem and CommonSpirit to remain at the negotiating table and to reach a deal to bring CommonSpirit back in-network for consumers enrolled in Anthem health plans. Unfortunately, Coloradans are the ones caught in the middle when large health systems and large insurers fail to reach an agreement,” said Colorado Insurance Commissioner Michael Conway. “As Anthem and CommonSpirit continue to work towards a new agreement, they must be cognizant that increased health care costs are ultimately borne by those same consumers in increased premiums. We have all worked very hard to keep health care costs under control for the benefit of Coloradans – it is important that work continues in these negotiations.”

Because this involves a large health insurer and a large hospital system, this situation will create many questions for people with various health care needs. With that in mind, the DOI has created a list of frequently asked questions (FAQs) to help guide people through this disruption.

Colorado DOI FAQs – Anthem / CommonSpirit Health

Anthem members should also reference information that Anthem has sent or that is available through member resources such as the anthem.com website or Anthem’s “Sydney” Health App. Members can also contact Anthem through the phone number listed on the back of their insurance ID card, by calling member services at 855-837-8536, or by logging into their online account and sending a request electronically.

Anthem has a website specific to this issue – anthem.com/commonspiritco – that contains information about the specific facilities impacted along with member resources. CommonSpirit has also created a website with information for its patients who have a health plan from Anthem – mountain.commonspirit.org/anthem#_self.

Adequate Network and Access to Care

While these contract negotiations continue to take place, the DOI will work to ensure that Anthem has an adequate health care provider network. The DOI will continue to make sure that all members are able to access the care they need from in-network providers, and if that access is inadequate, that Anthem will approve those members going out-of-network at no greater cost to the member as if they went to an in-network provider.

Continuity of Care

Anthem is also providing assistance to ensure continuity of care for members in the following situations: pregnant, undergoing a course of treatment for a serious and complex medical condition, undergoing a course of inpatient care, terminally ill, scheduled to undergo nonelective surgery, or have already obtained a prior authorization for services. Members should contact Anthem to find out if they are eligible for continuity of care – contact Anthem through the phone number listed on the back of your insurance ID card, member services at 855-837-8536, or by logging into your online account and sending a request electronically.

Anyone experiencing issues with Anthem regarding any of these issues should contact the Colorado Division of Insurance Consumer Services Team – 303-894-7490 / DORA_Insurance@state.co.us / doi.colorado.gov (click on “File a Complaint”).

###

About the Division of Insurance:

The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit doi.colorado.gov for more information or call 303-894-7499 / toll free 800-930-3745.

About DORA:

DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 800-886-7675.

Here to Help

HomeTown Insurance and Financial Services is here to help! We can ensure your insurance and financial well-being are taken care of by listening to you. Send us a secure note here, or give us a call at (970) 264-4321.  If you just want to text, we can do that too!  Send your text message inquiries to: (970) 444-2595.

Home Based Business? Affordable Coverage for Some Peace of Mind

Insurance, Home Based Business Home based small business has seen a boom over the last year.  Work-from-home jobs require business equipment, and probably even time on the road.  Coverage that reaches beyond a homeowner's policy, can provide peace of mind for you in...

Special Enrollment Information – How to Enroll Outside of an Open Enrollment Period

insurance, health-plans, special-enrollment This is information for those who might be looking for health insurance coverage outside of Open Enrollment. Enrolling in a plan outside of Open Enrollment is available for people who have experienced a recent change in life...

The Sign-Up Window Closes, January 15th for 2022 Open Enrollment

open-enrollment, affordable-care-act, health-insurance Health Insurance for 2022 Health coverage for 2022?  Get in touch with us by January 15, and we can secure your health insurance plan for the rest of the year.  Open enrollment for 2022 health plan coverage comes...
RV pro tips, RV insurance

Insure your RV + Some RV Pro Tips to make your long trips easier

Recreational Vehicle Insurance & Tips to Help you enjoy the ride Need to insure your RV? HomeTown Insurance & Financial Services is here for you.Traveling with a recreational vehicle can mean getting to see lots of sites, and taking some of the conveniences of...
Looking for multi-state P&C coverage? We can help you out with that too! Check out more here. Serving, Arizona, Colorado, New Mexico, and Texas for Property and Casualty Insurance.

We’re your hometown agency, HomeTown Insurance and Financial Services, llc. Colorado insurance professionals, offering service across the state. Colorado Springs, Pagosa Springs, Pueblo, to Grand Junction and everything between. Certified insurance brokers. We carry insurance of all types for New Mexico too! Chama, Santa-Fe, Gallup, to Farmington, and more. Let us know your insurance questions, and we’ll get you answers!

We know lots of folks keep properties in multiple states! That’s whey we specialize in Property and Casualty coverage for Arizona, Colorado, New Mexico, and Texas. Make it easy with HomeTown service for your multi-state properties!

Ask Us Anything!

Use any of the contact forms on our website to send a secure message to us at HomeTown Insurance & Financial Services.

Custom Insurance Quotes, Questions, Appointment Inquiries, or Just About Anything Else

Use this, or any of the secure contact forms on our website to send us a note regarding anything.  Send HomeTown Insurance & Financial Services a detailed message, and we’ll get back to you. Thanks!!

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.