Questions and Answers
Why does the university use medical provider networks for its medical plans?
These provider networks are essential for a variety of reasons, such as: 1) credentialing providers and monitoring malpractice issues, 2) providing substantial discounts off billed charges, 3) referrals to other network providers, 4) submitting claims to insurance/administrative companies, and 4) assuring no “balance billing” of members for excessive fees. All of the Indiana University-sponsored medical plans for employees take advantage of these “preferred provider” network features.
Why does the university use Anthem networks for its medical plans?
IU employees expect that the university will provide comprehensive medical plans that are affordable and the university needs these to recruit and retain highly qualified staff and faculty. Only a network manager the size of Anthem (1.4 million covered members in Indiana) has the volume to negotiate the discounts that result in the premiums employees have come to expect. Using another provider network would result in meaningful premium increases for employees and the university, or reductions in benefits for employees. Anthem’s networks also provide seamless coverage throughout the country and overseas where university employees are located.
Which IU-sponsored plans use Anthem networks?
The HDHP PPO & HSA, PPO $900 Deductible, PPO $400 Deductible plans use Anthem networks for medical services. The Premier contract that is expiring has no impact on the Anthem Blue Retiree (IU Medicare-eligible Retirees), nor prescription benefits under any of the IU-sponsored plans.
Does the Premier contract just include services at the Landmark Center facility?
No. Premier is a large corporate health care system that also includes a variety of other service locations under its umbrella.
I have used the Premier walk-in clinic for urgent care in the past. What alternatives will I have?
Some physician’s offices may have extended hours for urgent care. Other walk-in clinics in Bloomington include First Health Care (812- 339-9980) on the west side, and IU Health Urgent Care centers on the east and west sides of town.
In addition IU has partnered with IU Health to offer same-day scheduling at locations on the south and east sides of town and in Ellettsville, Gosport, Nashville, and Spencer.
How can I find out where I can get my medical services in-network?
You can call Anthem’s Customer Service at 800-345-2460 or go to Anthem's Provider Finder to locate participating provider locations. If you are unsure what type of provider can duplicate the services that you are currently receiving at Premier, ask your physician for names of providers for Anthem to check for network status.
How can I minimize my out-of-network cost if I continue to see an Premier provider?
Even if you continue to see an out-of-network physician for an office visit, these in-network services may be available.
Are out-of-network benefits applied on the basis of when the service is provided or when the claim is paid?
When the service is provided.
What if after Novermber 1 I believe I have a claim that paid out-of-network in error?
Contact Anthem customer service at 800-345-2460.
