Anthem Blue Cross and Blue Shield and MU Health Care Announce New Agreement
February 13, 2025The agreement restores in-network access for Anthem commercial members across Central Missouri
University of Missouri Health Care (MU Health Care) and Anthem Blue Cross and Blue Shield in Missouri (Anthem) have agreed to restore in-network access to all MU Health Care providers and facilities for Anthem’s commercial health plan members, including those enrolled in self-funded and fully insured employer-sponsored plans and Affordable Care Act (ACA) marketplace plans. Anthem’s Medicare Advantage HMO and PPO plans remain out of network as previously notified.
Frequently Asked Questions (FAQs)
Q: Has Anthem reached a new agreement with MU Health Care?
A: Yes. University of Missouri Health Care (MU Health Care) and Anthem Blue Cross and Blue Shield in Missouri (Anthem) have agreed to restore in-network access to all MU Health Care providers and facilities for Anthem’s commercial health plan members. This includes members enrolled in:
- Self-funded employer-sponsored plans
- Fully insured employer-sponsored plans
- Affordable Care Act (ACA) marketplace plans
Q: When does in-network access resume?
A: In-network access is restored retroactive to April 1, 2025. Anthem and MU Health Care are working closely to ensure a seamless return to in-network care for members who wish to resume seeing MU Health Care providers. Members who sought care from other in-network providers during this time may continue seeing those providers without disruption.
Q: Are Medicare Advantage members included in the agreement?
A: No. Anthem’s Medicare Advantage HMO and PPO plans remain out-of-network as previously notified. This agreement applies only to commercial health plan members.
Q: Will care received between April 1 and now be considered in-network?
A: Yes. Claims for services received at MU Health Care on or after April 1, 2025, may be reprocessed as in-network.
Q: I paid out-of-pocket between April 1 and now. Will I be reimbursed?
A: You may be eligible. Please contact MU Health Care to request a refund. MU Health Care will resubmit the claim to Anthem for processing. Keep any receipts, bills, or Explanation of Benefits (EOBs) related to your care during this time.
Q: I received a check from Anthem. What should I do?
A:
- If you received a check and did not cash the check: Please do not cash any reimbursement checks you may have received. Anthem will place a stop payment on that check. The claims related to that check will be refiled by MU Health Care and paid directly by Anthem. If you have not yet paid your in-network cost-share, you will need to pay that to MU Health Care.
- If you received a check, cashed it, and paid MU Health Care: MU Health Care and Anthem will reprocess the claim and any payment that you made for the out of network care will be refunded by MU Health Care.
- If you received a check, cashed it and have not yet paid MU Health Care: Please call the number on your ID card to receive additional instructions for how to proceed.
- Anthem will be calling members that received a check at the number we have on file for the member who received services. If you do not have a phone number included in your profile, or need to update the number, you can do so on the Sydney Health app or call the Member Services number on your ID card.
Q: When will I receive my reimbursement, if eligible?
A: Timing will vary depending on when your claim is reprocessed and your plan details.
Q: How will I know if my claim has been reprocessed?
A: You will receive an updated Explanation of Benefits (EOBs) showing in-network processing and any applicable adjustments.
Q: Will my deductible and out-of-pocket maximums be adjusted?
A: Yes. Once your claims are reprocessed, in-network cost sharing will apply. Any overpayments will be corrected and applied to your deductible and out-of-pocket maximum.
Q: Do I need to submit anything to get reimbursed?
A: In most cases, MU Health Care will refile the claim on your behalf. If you paid out-of-pocket and haven’t yet received a refund, you may need to contact MU Health Care. More details will be shared if member action is required.
Q: What does this mean for claims from earlier in the year?
A: Anthem plans to reprocess eligible MU Health Care claims for dates of service on or after April 1, 2025, applying in-network benefits.
Q: Who do I contact for help?
A: Call the Member Services number on your Anthem ID card, use the Sydney Health app, or check this site for updates and assistance.
If you have immediate questions, please call the Member Services number on your Anthem ID card. We appreciate your patience and remain committed to supporting you during this transition.
