Balance Billing legislation prompts changes to provider directory information

Virginia’s Balance Billing legislation (SB172/HB1251) goes into effect January 1, 2021.  (Balance billing often occurs when a member receives care from an out-of-network provider at a network-participating facility.) This new legislation protects eligible members from balance billing when certain services are rendered by an out-of-network provider.  

 

As a requirement of this legislation, Anthem Blue Cross and Blue Shield and our affiliate HealthKeepers, Inc. will begin displaying hospital-based providers in our provider directories.  Historically, information regarding these types of providers has been suppressed from the provider directories, as members do not typically schedule direct appointments for services of these providers.  This change allows our members to verify our in-network, hospital-based providers (such as Radiologists, Pathologists, Emergency Medicine providers, Anesthesiologists, and others).  This change will occur in mid- to late November.  For more information about this new legislation, please refer to the State Corporation Commissions website at the following link: https://www.scc.virginia.gov/pages/Balance-Billing-(1).

 

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