Update on contract negotiations between LewisGale ER group and Anthem

From: The Division of Human Resources

Negotiations continue between Anthem and the management group, Schumacher Clinical Partners, for many emergency room (ER) physicians in LewisGale facilities. While negotiations between Anthem and Schumacher are ongoing, the physicians in certain LewisGale ERs are out-of-network for Anthem members; however, we have confirmed that the ER physicians are still accepting Anthem out-of-network rates for care and members will only owe the co-insurance and deductible amounts. Click here for a letter from Schumacher Clinical Partners and a list of ERs.

If you or a covered dependent receive care at a LewisGale ER and are billed out-of-network rates, please DO NOT ignore the bill. Follow the actions outlined below:

  1. After ER services are incurred, you will receive an Explanation of Benefits (EOB) and a check from Anthem, and a bill from EMBCC, the billing agent for Schumacher Clinical Partners.
  2. Deposit the check into your personal bank account and retain the check stub or documentation certifying the amount.
  3. Send a personal check for the amount you received from Anthem to EMBCC, along with a copy of the applicable EOB to EBMCC, P.O. Box 731584, Dallas, TX 75373-1584.

If you have questions about this process, you may contact EMBCC at pcc@embcc.com or 888-703-3301. Their hours of operation are Monday – Thursday, 8 a.m. – 7 p.m. CST and Friday, 8 a.m. – 5 p.m. CST.   

The Division of Human Resources also has a dedicated insurance specialist that can help employees covered by state health insurance plans navigate this process. If you need help from human resources, contact the HR Service Center at hrservicecenter@vt.edu or 540-231-9331.