Some Western employees might have to find a new doctor because of disagreements between Western’s health care provider and Bowling Green Medical Clinic.
BGMC, on Ashley Circle, is no longer in Anthem Blue Cross and Blue Shield’s health insurance network because of reimbursement disagreements, said a representative from the clinic’s health insurance department.
The representative asked to not be named.
English Professor Deborah Logan said she is organizing a meeting on Monday for Western faculty and staff and Anthem and BGMC officials to get information and discuss the change.
She said she sent an e-mail to all faculty and staff asking for the reasons behind the change, but she hasn’t had any responses.
Anthem insurance is an option for all Western employees, said Kari Aikins, manager of employee benefits and retirement for human resources.
BGMC was part of Anthem’s network, the group of medical providers that people can go to for a discounted rate, Aikins said.
She said the employees can still go to BGMC, but they will pay a higher rate.
President Gary Ransdell said Anthem is Western’s third party administrator. They bill the health care providers and negotiate prices for the care.
Western employees pay into an insurance fund that pays health care costs, he said.
Ransdell said Western officials aren’t involved in reimbursement discussions.
“Anthem is representing our best interest, and that’s what we pay them to do,” he said. “I’m not saying right or wrong, but it’s between the doctors and Anthem.”
The BGMC representative said the amount Anthem officials wanted to pay the clinic’s doctors was less than what clinic officials thought was acceptable.
The minimal acceptable amount of reimbursement is what Medicare pays, the representative said. That price varies for each procedure.
The representative said Anthem and BGMC officials have been in discussion for 90 days.
Anthem officials couldn’t be reached for comment.
Trish Jaggers, office associate in the women’s studies department, said her family has gone to a doctor at BGMC for 17 years.
“You choose your doctor carefully because this person is in charge of your health and well being,” Jaggers said.
Jaggers said she thinks Western employees were “kept in the dark” about their health insurance.
“Four hundred dollars of my paycheck each month goes to Anthem; therefore, I have a voice, and I am angry,” she said.
Aikins said they are asking Anthem and BGMC officials to continue discussing an agreement.
“We don’t have control over the network itself, so we can’t tell them what to do,” Aikins said.
She said human resource officials might go to the meeting on Monday.
Reach Christina Howerton at news@chherald.com.

















