On April 1, 2018, the contract between Blue Cross Blue Shield of Georgia (BCBSGA), the largest health insurance carrier in Georgia, and Piedmont Healthcare, Inc., to include Piedmont Clinic Physician Practices, will expire if an agreement is not met. Contract negotiations are ongoing. While BCBSGA and Piedmont are hopeful an agreement will be reached, both parties recently mailed letters to impacted members advising them of the potential network change. If an agreement is not reached, non-emergency claims for all care provided by Piedmont will be considered out-of-network and reimbursed as out-of-network, beginning April 1, 2018.
If plan enrollees have services or procedures scheduled with one of the Piedmont hospitals, facilities or care providers, they may be eligible for Continuity of Care. Under specified circumstances, plan enrollees may be able to continue services at a Piedmont facility or with a Piedmont doctor as an In-Network benefit. To determine eligibility for Continuity of Care, plan enrollees and their physician must fill out the attached Continuity of Care form and submit to BCBSGA for review.
Additionally, BCBSGA established a page dedicated to the Piedmont contract negotiations on their web site at www.bcbsga.com/piedmont. GDA Plus+ Insurance/GDIS will continue to communicate updates on this important matter.
BCBSGa Continuity of Care Form (PDF)