February 01, 2018

SPM Tells Anthem to Reconsider Outpatient Imaging Policy

The Society for Participatory Medicine (SPM) recently sent a letter to Anthem urging the nation’s largest Blue Cross Blue Shield plan to reconsider its outpatient imaging payment policy.

With only a few exceptions, the Anthem policy effectively denies payment for advanced imaging performed in the hospital outpatient department.

“By removing advanced imaging from hospital settings and moving it exclusively to freestanding imaging
centers, Anthem is using the threat of non-reimbursement to take decision-making ability away from physicians and their patients,” said the SPM letter.

The Anthem policy may force patients to forego care at facilities with which they may have a previous relationship and travel up to 30 miles to receive advanced imaging care.

“Patients can only make informed and adequate health care decisions when they have knowledge of the process and access to all possible options. This policy takes choice away from the patient, severely limiting his or her ability to make the right decision at the appropriate time.”

Click here to read a copy of the Society for Participatory Medicine letter to Anthem.