USG to Absorb Piedmont Out-of-Network Costs for 30 Days

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Summaries

Summary Sentence:

Georgia Governor Nathan Deal announced Tuesday that the state and University System of Georgia will absorb out-of-network claims for affected employees and their dependents for up to 30 days.

Full Summary:

Georgia Governor Nathan Deal announced Tuesday that the state and University System of Georgia will absorb out-of-network claims for affected employees and their dependents for up to 30 days.

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  • University System of Georgia University System of Georgia
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Georgia Governor Nathan Deal announced Tuesday that the state and University System of Georgia (USG) will absorb out-of-network claims for affected employees and their dependents for up to 30 days in order to minimize patients’ financial burden during ongoing negotiations between Blue Cross Blue Shield of Georgia and Piedmont HealthCare.

“We want to make sure University System of Georgia families have access to the care they need and this 30-day extension is a necessary step to provide coverage for our employees,” said USG Chancellor Steve Wrigley in Tuesday’s announcement.

Georgia Tech Human Resources notified employees of the update Tuesday afternoon.

For employees who are enrolled in a USG health care plan with Blue Cross Blue Shield of Georgia (BCBSGa), and who use a Piedmont HealthCare provider or facility for healthcare services, read more information below.

What happens at the end of the 30-day transition period? 

If BCBSGa and Piedmont HealthCare have not reached an agreement by April 30, 2018, any claims incurred with Piedmont-affiliated providers will be processed as out-of-network claims beginning May 1, 2018.

Should I still apply for Continuation of Care with my Piedmont HealthCare provider under my USG BCBSGa healthcare plan?

Yes. If an agreement is not reached by April 30, and you think you may be eligible for Continuation of Care beginning May 1, please call the dedicated BCBSGa Customer Service team at 1-800-424-8950. You will then need to complete and submit a form to request Continuation of Care. The Continuation of Care form found here (pdf).

Continuation of Care will be considered, but not guaranteed, for approval of services such as: 

  • Completing a course of treatment.
  • An active course of treatment for cancer.
  • Pregnancy services (any trimester).
  • Being treated for a terminal illness or hospice care.
  • Undergoing transplant care or waiting for a transplant.
  • Being treated for a serious medical or behavioral health condition.

Some conditions that don’t qualify for Continuation of Care include but are not limited to: 

  • Routine exams, vaccinations, and health assessments.
  • Ongoing conditions you may have but are being managed, such as diabetes, arthritis, allergies, depression, asthma, hypertension (high blood pressure), and glaucoma.
  • Elective (non-urgent) inpatient and/or outpatient surgery. 

How can I stay informed about Piedmont’s status? 

Click here for the most up-to-date information or call the Member Services number on your BCBSGa ID card at 1-800-424-8950. 

Also look for information that will be posted on the USG Benefits website.

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Keywords
health care, benefits, OHR, human resources, usg, University System of Georgia, employees
Status
  • Created By: Kristen Bailey
  • Workflow Status: Published
  • Created On: Apr 4, 2018 - 9:38am
  • Last Updated: Apr 4, 2018 - 10:20am