11.17.2023 Update

Samaritan Healthcare and Premera have come to an agreement on a 1-year contract, providing no disruption to Premera patients receiving care at Samaritan Hospital or Clinics. This 1-year contract is effective through December 31, 2024.

The new contract allows members across all Premera lines of business (commercial, individual, and Medicare advantage) to retain in-network access to healthcare services in 2024. While discussions on a long-term contract continues, Samaritan will provide updates to our patients and community. For any additional questions, patients may call (509)764-3336 or email contracting@samaritanhealthcare.com.

Samaritan entered negotiations with Premera with the goal of continuing to provide access to local high-quality care for those ensured by Premera, as well as fair reimbursement for services provided. The new contract represents collaboration between two organizations that aims to provide stability and access to care for patients throughout Central Washington.

Samaritan appreciates the patience and understanding of our community members as we’ve worked through this. Samaritan Healthcare remains committed to reaching a multi-year agreement that ensures there is no disruption for Samaritan patients who are covered by Premera.

10.20.2023 Update

In an effort to keep our community updated on the ongoing negotiations with Premera, we wanted to take moment to provide the following update:

“We are committed first and foremost to caring for the patients of our community, regardless of their insurance or ability to pay. As a community-owned hospital district, we are committed to being stewards of our resources. As such, we have a responsibility to ensure that we have contracts with payers with appropriate payment that will allow us to support our patients, our mission, and advance healthcare services for our region.”

“There has been recent progress in negotiations with Premera. We appreciate that they have been working with us. Samaritan’s goal is to negotiate a contract that benefits regional patients and brings Premera’s contract in line with other commercial insurance payers and reflects the increased costs due to inflation that has impacted not just Samaritan but all of healthcare as well as many other industries.”

Samaritan Healthcare is working to renegotiate contracts with Premera Blue Cross, which are set to end on December 31, 2023. As a long-standing community partner, we are concerned about our patients and remain committed to continuing contract discussions in an effort to negotiate reimbursement rates that fairly address the cost of providing care to our community.

If the contracts are not renewed, effective January 1, 2024, Samaritan Healthcare patients with health insurance through Premera may experience a change in coverage for services. This means that Premera may not cover the cost of care at current levels, and as a result, Premera patients may need to pay a larger share of their medical costs, up to the full cost of the services provided.

We value our relationship with you and hope to continue being your partner for healthcare. For more information, please see the Frequently Asked Questions (FAQ) below.

If you have additional questions, please contact us at Contracting@SamaritanHealthcare.com or (509) 764-3336. Contact your Premera health plan directly with any questions regarding authorization for services scheduled on or after January 1, 2024.

Q: What is the status of Samaritan Healthcare’s contracts with Premera?
A: Samaritan Healthcare’s contracts with Premera will end on December 31, 2023, unless they are renewed.

Q: Is Samaritan Healthcare still negotiating with Premera?
A: Samaritan Healthcare is concerned about the impact that a contract termination could have on Premera patients, and we are continuing our contract discussions. We are committed to engaging in productive discussions with Premera to negotiate reimbursement rates that fairly address the costs of care. We will provide updates to our patients on any new developments.

Q: How will this change affect my healthcare services at Samaritan Healthcare?
A: If we are unable to reach an agreement with Premera, this contract termination, effective January 1, 2024, will affect all patients with Premera coverage.

Premera patients may need to pay a larger share of their medical costs, up to the full cost of the services provided. This will include services received by Premera patients at Samaritan Hospital, Samaritan Clinic on Pioneer, and Samaritan Clinic on Patton.

Premera patients who choose to receive services after January 1, 2024, from Samaritan Healthcare will be asked to sign standard documents to indicate that the patient accepts this larger share of financial responsibility for their medical costs.

Please note that even where Premera has authorized services beyond January 1, 2024, Premera patients may still be responsible for these higher charges.

Q: Can I still make appointments and schedule procedures with the hospital and medical professionals at Samaritan Healthcare after January 1, 2024?
A: Yes, you will still be able to make appointments and schedule procedures with Samaritan Healthcare after January 1, 2024. However, unless otherwise stated, Samaritan Healthcare will no longer be a contracted provider of services for Premera patients. To see your options for continuing care at Samaritan Healthcare, please contact your Premera insurance plan about coverage.

If your health insurance plan is sponsored by your employer, we also encourage you to contact your employer’s Human Resources or Benefits department to request a plan that includes Samaritan Healthcare.

Q: What if I am pregnant after January 1, 2024?
A: If you are a current obstetrics patient, Samaritan Healthcare will make every effort to avoid a disruption in your care and will work with Premera to maintain ongoing coverage for services beyond January 1, 2024. If an arrangement cannot be made, you may need to pay a larger share of your medical costs, up to the full cost of the services provided.

Continued coverage for these types of care is governed by the No Surprises Act. In the event of a contract termination, this federal law requires that health insurance companies provide continuity of care benefits to patients receiving treatment for a covered serious and complex or chronic medical condition. These conditions include pregnancy, long-term or chronic illness, or scheduled non-elective surgery. Learn more about the No Surprises Act here.

Please contact your Premera health plan or your employer’s Human Resources department for any questions regarding coverage, including continuity of care and out-of-network benefit options for service.

Q: How do I find a medical professional to cover my care after January 1, 2024?
A: Contact your Premera insurance plan with questions about coverage.

Q: How do I get my medical records?
A: Contact Samaritan Healthcare’s Health Information Management department at (509) 765-5606 ext. 1160 or ext. 1161, Monday through Friday, 8:00 a.m. – 4:30 p.m.

Q: What if I need to go to an emergency room?
A: This change does not affect emergency medical care at Samaritan Healthcare. You can always receive care at emergency rooms, regardless of insurance. Emergency services are covered under your benefits, but if you are subsequently admitted to Samaritan Healthcare, you may incur higher out-of-pocket costs.

Q: How will my outstanding claims be handled?
A: Claims for services provided before December 31, 2023, will be processed as usual. Effective January 1, 2024, claims may be processed as “non-contracted” services. This means that patients may need to pay a larger share of their medical costs, up to the full cost of the services provided.

Q: If I have not paid my bill for services provided on or before December 31, 2023, will my bills be processed as contracted?
A: Services provided on or before December 31, 2023, will be processed as contracted.

Q: Will I still have access to MyChart after January 1, 2024?
A: Yes, patients will continue to have access to MyChart accounts following this change.

Q: Who should I contact?
A:

• For members with employer sponsored plans, contact your employer’s Human Resources department, or:
  • Premera Blue Cross Members: (800) 722-1471
  • Premera Blue Cross HMO Members: (844) 722-4661
  • Outside of U.S.: (855) 629-0987
  • Open weekdays 5 a.m. to 8 p.m. pacific time

• If you bought your plan directly from Premera or through WAHealthPlanFinder.org:
  • (800) 607-0546
  • Outside of the U.S.: (855) 629-0987
  • Open weekdays 8 a.m. to 6 p.m. pacific time

• For LifeWise Members:
  • (800) 817-3056
  • Outside of the U.S.: (855) 332-2159

• For Medicare Advantage Members:
  • (888) 850-8526

• For Medicare Supplement Members:
  • (800) 722-1471
  • Public Employees Benefits Board (PEBB) Members: (888) 208-6264

• Premera TDD/TTY number for deaf, hard of hearing, or speech-impaired members is 711.

• Sign in to your account and submit a secure email to Premera at the link here.

• Premera Corporate Offices: Open weekdays 8 a.m. to 5 p.m. pacific time