Sarah Bush Lincoln Leaves Network
April 11, 2018Sarah Bush Lincoln Health Center gave notice that it will end its contract with us on June 30, 2018. This means as of July 1, 2018, Sarah Bush Lincoln will be considered out-of-network for our commercial group and individual members. While we are disappointed in the decision, we’d like to remind you of our continuity of care guidelines to help best serve our members.
Sarah Bush Lincoln will still be considered a network hospital for our Medicare members, and members on any of our plans can use it for emergency care at the in-network rate. We always cover emergency services as if they were in-network, regardless of whether the hospital is in- or out-of-network.
When a primary care provider or specialist leaves our network, any member who is in an ongoing course of treatment may be eligible to continue care with the termed provider (if certain criteria are met) during a 90-day transitional period. Any member in the 13th week or more of pregnancy may be eligible to continue care with the termed provider through post-partum care. You must request coverage for transitional care within 30 days of receiving notice.
Members with prescription coverage can also fill any remaining prescription refills after the prescribing provider leaves the network.
Our network remains strong and still gives members many options for local health care, including Carle Clinic in Mattoon. Our network also includes these hospitals:
- Carle Foundation Hospital in Urbana
- Carle Richland Memorial Hospital in Olney
- Crawford Memorial Hospital in Robinson
- Decatur Memorial Hospital
- HSHS Good Shepherd Hospital in Shelbyville
- HSHS St. Anthony’s Memorial Hospital in Effingham
- HSHS St. Mary’s Hospital in Decatur
- OSF Healthcare Heart of Mary Medical Center in Urbana
- Pana Community Hospital
- Paris Community Hospital
We are sending letters and a flier highlighting remaining in-network options to affected members and employers:
- Letter for patients with a Sarah Bush Lincoln PCP
- Letter to patients with a Sarah Bush Lincoln specialist
- Letter to all other Health Alliance subscribers in the service area who are not Sarah Bush Lincoln patients
- Letter to employers
- Network promotion flier
If you have any questions about this, contact your provider relations specialist or call us at 1-800-851-3379.