Dear _____:

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It is my understanding that you are involved with selecting insurance options for state employees.  I would like to report (and have it be recorded) that I am not satisfied with Anthem's results.

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Anthem is undermining my ability to receive high quality medical care.  Specifically- Anthem has forced Kentucky Breast Care “out of network”.  Anthem’s efforts to increase its own profits are putting my healthcare at risk!

 

KBC is my clinic of choice because they provide the highest level of medical care. 

Only KBC:

• uses cutting edge technology, facilities, and provide superior customer service/follow up;

• has the only breast fellowship-trained radiologist in our area;

• has the most experience finding breast cancer in our region; 

• frequently corrects patient mismanagement by hospitals/clinics (that only have general radiologists, not fellowship trained breast specialists).

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In addition, some of the other clinics on Anthem’s list of providers are NOT following the Guidelines of the American College of Radiology.

One Example- Anthem is reimbursing non-qualified clinics to conduct diagnostic breast procedures WITHOUT a radiologist on site (which is not in compliance with the ACR Guidelines) ... and represents a legal risk.

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Anthem has also communicated to KBC that they will not be facilitating "Continuance of Care" for the vast majority of patients that are currently experiencing an acute issue.  "Continuance of Care" is supposed to apply to patients that are in the middle of treatment/follow-up on a particular breast issue (Cancer, Mass, etc.).  Anthem has already started recommending these patients pursue care at facilities that do NOT have breast specialists... which puts those patients at risk.

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Other insurance carriers recognize KBC as the “provider of choice” and KBC helps everyone avoid overall medical costs, especially: “downstream” costs from avoided surgeries, treatments, hospitalizations, etc..  

 

I am disappointed that Anthem does not want to provide the same high-quality medical care as other insurance companies!

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Please consider this information when the Anthem's state-wide contract is up for renewal.  Please also forward this letter to anyone else who has some oversight of Anthem's activities.

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Sincerely,

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Your Name

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