In a big step forward for Covered California’s ability to serve residents of the Tri-Counties, Sansum Clinic said late Friday afternoon that its 23 outpatient medical clinics will serve patients who buy Anthem Blue Cross coverage on the state’s online health insurance exchange.
Sansum is one of the largest primary patient care providers in Covered California’s District 12, which includes Santa Barbara, Ventura and San Luis Obispo counties.
Lack of access to Anthem Blue Cross coverage through the state exchange had created a stumbling block for thousands of eligible people in the region. Indeed, because it did not have agreements with the exchange’s two providers, Anthem Blue Cross or Blue Shield of California, Sansum Clinic was not listed as a member of the network.
“It’s a big breakthrough for the community,” Sansum CEO Dr. Kurt Ransohoff told The Business Times in a phone interview. “I have heard from many of my patients that they needed to get new insurance.”
Sansum said in a statement that by early December the Anthem Blue Cross website should list Sansum Clinic as a member of the exchange but said it was not clear when Sansum would be added to the Covered California website.
Ransohoff said Sansum was taking a decrease in its rates in order to join the network, but he also agreed that by being part of the exchange Sansum will be able to attract patients who are able to afford insurance coverage for the first time.
Sansum has not reached an agreement with Blue Shield of California, the other provider of insurance via Covered California. However, it has reach an accord with the University of California to be a Tier 1 provider on its UC Care preferred provider program.
“We’re thrilled to be the only insurer to have Sansum Clinic in our exchange network,” Ernie Schwefler, regional vice president of provider contracting at Anthem Blue Cross said in the statement.
For information about how to sign up for Covered California with Anthem Blue Cross, area residents can contract a health insurance broker or call (866) 791-5538 starting on Monday, Nov. 25. Californians who want their insurance coverage
through the exchange to start on Jan. 1, 2014 must enroll by Dec. 23.
Sansum said it would continue to update its web ite at www.SansumClinic.org/health-plans to additional information about health insurance information and resources.