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Amy Umble is health reporter for The Free Lance-Star

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Happy ending for woman who was reluctant to schedule cancer test

Updating the Anthem-Mary Washington contract dispute.

The case of the local woman who was reluctant to schedule a cancer test because of uncertainty with her insurance coverage appears to have been resolved.

A Mary Washington Healthcare official said this afternoon that the company has reached an agreement with the woman, her doctor and her health insurer, Anthem Blue Cross and Blue Shield.

“We’ve worked it out so that she’s going to be able to get her care and only pay what she would have paid if we were in network,” said Eric Fletcher, spokesman for MWHC.

The woman confirmed the arrangement this afternoon and said that she is happy with it. She also said she hopes that others will be able to work out special coverage questions as she did.

Representatives of the Spotsylvania Regional Medical Center and Mary Washington offered to help the woman after learning about her predicament from a Tuesday blog post.

The woman, who asked that her name not be used, said that her doctor had recommended a test to relieve her gynecological symptoms and to test for uterine cancer. The woman hesitated to schedule the test since Mary Washington was no longer an Anthem provider, and since her Anthem plan did not have out-of-network benefits.

When she saw the post, Jeanne Burkett, spokeswoman for the Spotsylvania Regional, called to recommend that the woman contact Dr. George Chamoun, a gynecological oncologist, who works at the Spotsylvania hospital. Spotsylvania Regional is an Anthem provider.

Fletcher also called to say that the hospital wanted to work with the woman. This afternoon he said that Mary Washington had reached an agreement with the woman to charge her only what she would have paid had it remained in Anthem’s network.

“She’s going to have a letter to that effect, and she’s going to be able to schedule her procedure,” Fletcher said.

The woman said she will schedule the procedure for later this month.

(The Tuesday blog post about the woman can be seen here. Mary Washington has set up a 24-hour hotline to help patients deal with Anthem coverage questions. Fletcher said the company is willing to work with patients one-on-one to resolve their problems. The hotline number is 540/741-1010.)

Permalink: http://news.fredericksburg.com/rapidassessment/2012/01/05/happy-ending-for-woman-who-was-reluctant-to-schedule-cancer-test/