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Important Information About Shenandoah Emergency Medicine Specialists

May 26, 2021
May 26, 2021
 
Shenandoah Emergency Medicine Specialists (Shenandoah ER) has let us know that it plans to leave Anthem Blue Cross and Blue Shield and Anthem HealthKeepers plan networks on July 1, 2021. Shenandoah ER practices at Augusta Health in Fishersville, Virginia.
 
We understand how important it is for our members to have access to the doctors and hospitals they know and feel comfortable with. We are committed to making sure our members have access to high quality, affordable healthcare.
 
We would like to keep Shenandoah ER in our health plan networks, but we cannot agree to the rate increases they have asked for. These rates would have a significant impact on healthcare costs for Virginia consumers.
 
We will continue to work with Shenandoah ER and hope to reach an agreement that will keep them in our members’ health plans.
 
Important Information
 
Shenandoah ER informed Anthem Blue Cross and Blue Shield and Anthem HealthKeepers that it plans to leave our Virginia plans’ networks on July 1, 2021.
 
The following plan networks will be affected if we don’t reach an agreement with Shenandoah ER by July 1, 2021:
  • Anthem’s PAR/PPO health plans including the Blue Cross and Blue Shield Service Benefit Plan (also called the Federal Employee Health Benefits Program® or FEHB)
  • Anthem HealthKeepers HMO plans (including Anthem Individual health plans)
  • Anthem HealthKeepers Plus (Medallion 4.0 and the Commonwealth Coordinated Care Plus plans)
  • Anthem Medicare Advantage health plans
Shenandoah ER practices at Augusta Health in Fishersville, VA. Augusta Health is and will stay in Anthem's plan networks whether or not Anthem reaches a contract agreement with Shenandoah ER.
 
Members in and near Augusta County can receive emergency care from ER doctors in their plans' network at several hospitals and urgent care centers in the area. We included a list of these facilities in the Frequently Asked Questions (FAQ).
 
If they have a medical emergency, members should always go to the nearest emergency room. This includes Augusta Health. Anthem plans cover emergency care regardless of where members receive it. If members receive care from Shenandoah ER after they leave Anthem networks, Anthem will pay the member directly for the care, based on the members' benefits when they receive care in their plan's network. Members will be responsible for paying Shenandoah ER.
 
Why is This Happening?
 
Contract discussions between health insurers and healthcare providers are standard and routine. We value our relationship with Shenandoah ER, and we will keep working toward an agreement that keeps them in our plans' networks. We hope to reach an agreement before July 1, 2021.
 
We believe hospitals and doctors should be paid fairly for the care they provide our members, and this is reflected in the contract terms we have offered Shenandoah ER. The businesses and communities we serve in the Augusta County area, and across Virginia, rely on us to deliver access to affordable, high-quality healthcare. We value this trust and take our responsibility seriously.
 
We will keep this site updated with the latest information.
 
Frequently Asked Questions
 
Q: When does the current agreement between Anthem and Shenandoah ER end?
A: If we don't reach an agreement with Shenandoah ER, they will no longer be in Anthem Blue Cross and Blue Shield and Anthem HealthKeepers plan networks starting July 1, 2021. We will keep working with Shenandoah ER and hope we will reach a new agreement.
 
Q: What medical group is affected by these negotiations?
A: Shenandoah Emergency Medicine Specialists.
 
Q: Where does Shenandoah ER pracice medicine?
A: Shenandoah ER practices at Augusta Health in Fishersville, Virginia.
 
Q: Which plans will be affected if Shenandoah ER leaves Anthem’s networks?
A. The following plan networks will be affected if we don’t reach an agreement with Shenandoah ER by June 30, 2021:
  • Anthem’s PAR/PPO health plans including the Blue Cross and Blue Shield Service Benefit Plan (also called the Federal Employee Health Benefits Program® or FEHB
  • Anthem HealthKeepers HMO plans (including Anthem Individual health plans)
  • Anthem HealthKeepers Plus (Medallion 4.0 and the Commonwealth Coordinated Care Plus plans)
  • Anthem Medicare Advantage health plans.
Q: Is the hospital where Shenandoah ER practices still in Anthem’s network?
A: Yes. Augusta Health is and will stay in Anthem Blue Cross and Blue Shield and Anthem HealthKeepers plan networks.
 
Q: If Shenandoah ER leaves Anthem plan networks, what should members do if they need emergency care?
A: If they have a medical emergency, members should always go to the nearest emergency room. Anthem plans cover emergency care no matter where members receive it. Other urgent care centers and several other hospitals near Augusta Countyand in the surrounding areas have ER doctor groups. For a complete list of these facilities, members can use our Find Care tool on the Sydney HealthSM mobile app or by logging in to anthem.com. Member Services can answer questions and help members find care in their plan’s network.
 
Alternate Facilities for Shenandoah Emergency Medicine Specialists
 
Alternate facilities for the following Anthem network health plans:
  • Anthem Blue Cross and Blue Shield plans
  • Anthem HealthKeepers
  • Anthem HealthKeepers Plus (Medallion 4.0 /CCC+) plans
Alternate Provider
Name
Address
Distance from
Shenandoah  ER
Sentara RMH Medical Center 2010 Health Campus Dr., Harrisonburg, VA 22801 21.65 miles
University of Virginia Medical Center 1215 Lee St., Charlottesville, VA 22903 26.1 miles
Sentara Martha Jefferson Hospital 500 Martha Jefferson Dr., Charlottesville, VA 22911 29.49 miles
Carilion Stonewall Jackson
Hospital
1 Health Circle, Lexington, VA 24450 33.96 miles
Page Memorial Hospital 200 Memorial Dr., Luray, VA 22835 47.16 miles
Bath Community Hospital 106 Park Dr., Hot Springs, VA 24445 47.31 miles
Centra Health Inc. 1920 Atherholt Road, Lynchburg, VA 24501 48.95 miles
Lewisgale Hospital Alleghany 1 ARH Lane,
Low Moor, VA 24457
53.86 miles
Novant Health UVA Culpeper
Medical Center
501 Sunset Lane, Culpeper, VA 22701 57.49 miles
Shenandoah Memorial Hospital 759 S Main St, Woodstock, VA 22664 58.47 miles
 
Alternate Facilities for the Following Anthem Network Health Plans:
  • Medicare Advantage
Alternate Provider Name Address
Distance from
Shenandoah ER
Sentara RMH Medical Center 2010 Health Campus Dr., Harrisonburg, VA 22801 21.65 miles
University of Virginia Medical Center 1215 Lee St., Charlottesville, VA 22903 26.1 miles
Sentara Martha Jefferson Hospital 500 Martha Jefferson Dr., Charlottesville, VA 22911 29.49 miles
Page Memorial Hospital 200 Memorial Dr., Luray, VA 22835 47.16 miles
Bath Community Hospital 106 Park Dr., Hot Springs, VA 24445 47.31 miles
Centra Health Inc. 1920 Atherholt Road, Lynchburg, VA 24501 48.95 miles
Lewisgale Hospital
Alleghany
1 ARH Lane,
Low Moor, VA 24457
53.86 miles
Novant Health UVA Culpeper Medical Center 501 Sunset Lane, Culpeper, VA 22701 57.49 miles
Shenandoah Memorial Hospital 759 S. Main St., Woodstock, VA 22664 58.47 miles
 
Alternate urgent care centers for Shenandoah Emergency Medicine Specialists
 
Alternate Provider Name Address
Distance from
Shenandoah ER
MedExpress Urgent Care 1209 Richmond Ave., Suite
108 Staunton, VA 24401
4.5 miles
Valley Urgent Care and Occupational Medicine 119 University Blvd., Suite B, Harrisonburg, VA 22801 23.8 miles
MedExpress Urgent Care 1149 Seminole Trail
Charlottesville, VA 22901
26.4 miles
MedExpress Urgent Care 260 Pantops Center
Charlottesville, VA 22911
28.2 miles