8/16/2019 Scarpino Letter Re Empire Blue Cross and HealthAlliance

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HealthAlliance Hospitals Update:

Empire Blue Cross Blue Shield Insurance

June 1, 2016

Dear Community member,

HealthAlliance is working hard to ensure that high-quality healthcare is provided directly in our

communities. A vision for expanded care and financial strength is why we chose to partner with the

Westchester Medical Center Health Network (WMCHealth). This includes being part of a larger network

umbrella.

We are disappointed Empire Blue Cross Blue Shield has not recognized the contractual

reimbursement terms for HealthAlliance that it previously agreed to with WMCHealth. As a result,

Empire considers HealthAlliance Hospitals “out of network” as of today. We are equally

disappointed Empire will require its members to seek elective healthcare outside the community.

As you may have heard, ALL other WMCHealth hospitals, including nearby MidHudson Regional

Hospital located in Poughkeepsie, are in network with Empire (this information was omitted in Empire’s

communications to its members). WMCHealth is vigorously pursuing a legal remedy to ensure we are

fairly compensated for the quality care our talented staff provides.

We are doing many th ings to ensure all patients have access to the fine care and services they are used

to and deserve , including access protected by law to HealthAlliance Hospitals (including the Emergency

Department at the Broadway Campus, maternity at the Family Birth Place, the Infusion Center, and pre-

scheduled surgeries); HealthAlliance facilities (such as the Dialysis Center and Bridgeback); as well as

other high-quality WMCHealth hospitals, and even the Kingston Ambulatory Surgery Center (845-338-

4777).

Additionally, the HealthAlliance Medical Staff Office is working directly with our community’s 

 physicians to ensure they have the information and support they need to care for their patients. Physicians

not on staff at another in-network facility with Blue Cross Blue Shield were contacted and are in the

credentialing process with a comparable, high-quality facility we have confidence in. This will ensure that

 physicians will continue to provide the same great care by seeing their patients both in the hospital and in

their offices.

For Patients with Empir e as their pr imary insurance:

8/16/2019 Scarpino Letter Re Empire Blue Cross and HealthAlliance

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  Empire must cover all emergency cases at all HealthAlliance facilities.

  Patients currently undergoing treatment and care (for example, pregnant women, including

 postpartum care, or recurring services for treatment of chronic conditions or diseases)

will continue to be covered for care at HealthAlliance facilities.

  All services previously preauthorized must be covered by Empire.

  Patients/members will not be required to file claims with Empire.

For Patients with Medicare as their primary insurance and Empir e as supplemental :

  Patients will continue to be covered for  ALL care, emergent and non-emergent, at

HealthAlliance facilities.

  Patients/members will not be required to file claims with Empire.

  Empire may send payments for HealthAlliance claims directly to Patients. Patients can bring

these payments to the registration desk of any HealthAlliance facility or mail them to

HealthAlliance Billing Department 741 Grant Avenue, Lake Katrine NY 12449.

For Patients of M argaretvil le Hospital:

 

Patients will continue to be covered for ALL care, emergent and non-emergent, at MargaretvilleHospital. Excellus will honor Empire Blue Cross Blue Shield patients coming to Margaretville

Hospital.

We apologize for any inconvenience this might cause, but we are here to help. If you have questions

about coverage, care and services, please call us directly at 800-613-6617 so we can assist you while we

continue to pursue a fair and equitable arrangement with Empire.  

Sincerely,

David ScarpinoChief Executive OfficerHealthAlliance of the Hudson Valley

A member of the WMCHealth

Westchester Medical Center Health Network

Westchester Medical Center

Behavioral Health Center

Maria Fareri Children’s Hospital 100 Woods Road

Valhalla, NY 12595

Bon Secours Community Hospital

St. Joseph's Place

160 E Main Street

Port Jervis, NY 12771

Good Samaritan Hospital

255 Lafayette Avenue

Suffern, NY 10901

HealthAlliance:

Broadway Campus

396 Broadway

Kingston, NY 12401

HealthAlliance:

Mary’s Avenue Campus 

105 Mary’s Avenue 

Kingston, NY 12401

Margaretville Hospital

42084 State Highway 28

Margaretville, NY 12455

MidHudson Regional Hospital241 North Road

Poughkeepsie, NY 12601

St. Anthony Community Hospital

15 Maple Avenue

Warwick, NY 10990

Mountainside Residential Care42158 State Highway 28

Margaretville, NY 12455