OAKLAND, Calif. — Primary care startup Carbon Health blasted health insurer Elevance on Monday for paying it less than competitors and for also refusing to process out-of-network claims — a rare public escalation of the behind-the-scenes disputes between providers and payers.
San Francisco-based Carbon said that Elevance — formerly known as Anthem, which operates the Anthem Blue Cross plan in California — had refused to increase its payment rate in the state beyond 2013 levels, which was “no longer tenable as a livable wage.”
Carbon told STAT that Anthem Blue Cross was paying 40% to 60% below what other commercial plans paid, and in some cases less than three-quarters what it paid other independent providers for the same services, according to its own calculations based on publicly available pricing data. It also said Anthem Blue Cross paid Carbon less than the Medicare rate for most services.
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