Friday, June 22 , 2018, 9:17 am | Fog/Mist 60º


Local News

Sansum Clinic Still Not Accepting Blue Shield Plans Under State Insurance Exchange

Sansum Clinic may not reach an agreement with Blue Shield in time for local patients to get Covered California exchange health-insurance plans for Jan. 1.

The 23-clinic organization reached an agreement with Anthem Blue Cross at the end of November, but still hasn’t with Blue Shield, according to marketing director Jill Fonte.

That means local patients with Covered California state exchange plans through Anthem can use their insurance with Sansum doctors, but Blue Shield patients can’t — as of now.

Those are the only two insurance companies with health insurance exchange plans for Santa Barbara County.

California residents who want health insurance coverage starting Jan. 1 must sign up by Dec. 23, which was pushed back from the previous Dec. 15 deadline.

Sansum isn’t sure it will make a deal with Blue Shield in time, Fonte said.

“Our highest level executives continue talking with Blue Shield, and we remain hopeful, but we haven’t made a lot of progress,” she said.

Negotiations are centered on reimbursement rates that the clinics receive from insurance companies. Sansum Clinic did agree to a decrease with Anthem, but it found common ground, CEO Kurt Ransohoff told Noozhawk in November.

There are many independent doctors in the community who are accepting exchange plans as well, he noted, but Sansum represents 23 primary-care and specialty clinics on the South Coast that serve 61,000 patients per month.

Sansum discovered it was not included as a provider on the state insurance exchange in early October, when public enrollment began, and has been negotiating with insurance companies ever since.

The Patient Protection and Affordable Care Act, also known as Obamacare, provides for an expansion of Medi-Cal benefits and a statewide insurance exchange with subsidies available based on income, gender and age.

Noozhawk staff writer Giana Magnoli can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

Support Noozhawk Today

You are an important ally in our mission to deliver clear, objective, high-quality professional news reporting for Santa Barbara, Goleta and the rest of Santa Barbara County. Join the Hawks Club today to help keep Noozhawk soaring.

We offer four membership levels: $5 a month, $10 a month, $25 a month or $1 a week. Payments can be made through PayPal below, or click here for information on recurring credit-card payments.

Thank you for your vital support.

Become a Noozhawk Supporter

First name
Last name
Enter your email
Select your membership level

Payment Information

You are purchasing:

Payment Method

Pay by Credit Card:

Mastercard, Visa, American Express, Discover

Pay with Apple Pay or Google Pay:

Noozhawk partners with Stripe to provide secure invoicing and payments processing.

  • Ask
  • Vote
  • Investigate
  • Answer

Noozhawk Asks: What’s Your Question?

Welcome to Noozhawk Asks, a new feature in which you ask the questions, you help decide what Noozhawk investigates, and you work with us to find the answers.

Here’s how it works: You share your questions with us in the nearby box. In some cases, we may work with you to find the answers. In others, we may ask you to vote on your top choices to help us narrow the scope. And we’ll be regularly asking you for your feedback on a specific issue or topic.

We also expect to work together with the reader who asked the winning questions to find the answer together. Noozhawk’s objective is to come at questions from a place of curiosity and openness, and we believe a transparent collaboration is the key to achieve it.

The results of our investigation will be published here in this Noozhawk Asks section. Once or twice a month, we plan to do a review of what was asked and answered.

Thanks for asking!

Click Here to Get Started >

Reader Comments

Noozhawk is no longer accepting reader comments on our articles. Click here for the announcement. Readers are instead invited to submit letters to the editor by emailing them to [email protected]. Please provide your full name and community, as well as contact information for verification purposes only.

Daily Noozhawk

Subscribe to Noozhawk's A.M. Report, our free e-Bulletin sent out every day at 4:15 a.m. with Noozhawk's top stories, hand-picked by the editors.

Sign Up Now >