Adventist Health Sonora Terminates Blue Shield of California Contract
Sonora, CA – Adventist Health Sonora no longer has a contract with Blue Shield of California, leaving some patients with plenty of questions.
The contract ended at midnight on Friday, after 11 months of negotiations, with the hospital saying they were “deeply disappointed” they were unable to reach an agreement with the insurance company.
“We understand the frustration and concern that these circumstances can generate for our community,” shared hospital officials, adding, “Keeping high-quality healthcare services local for our community is our number one priority, and we need fair reimbursement rates from insurance companies to be able to continue meeting our community’s needs. As a system, Adventist Health must have rate increases that support our overall expenses in this highly inflationary environment—expenses that continue to exceed the reimbursement we receive from Blue Shield for caring for their members.”
Sonora’s hospital is one of 17 Adventist Health medical centers impacted by the lack of a contract across the state.
“Please be assured that we want to reach a reasonable agreement with Blue Shield,” added hospital officials. “Adventist Health remains open to negotiations and will provide updates should the situation change. We also encourage employers and community members with Blue Shield of California health insurance plans to contact Blue Shield with their concerns.”
To file grievances with Blue Shield of California, click here. There is an initial 30-day grace period after the contract termination that allows Blue Shield patients to access services at Adventist Health Sonora. Patients should call the phone number on their insurance card to confirm the details of this grace period for their specific plan. In addition, Blue Shield has an out-of-network referral form patients may use to request access to out-of-network facilities and providers when a patient would have to commute more than 30 miles from their home. For those details and frequently asked questions regarding the contract termination, click here.
