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Fore River Urology update

Fore River Urology became an out of network provider on August 1, 2022 for the MEA Choice Plus Plan and the MEA Standard Plans. They also became an out of network provider for our Medicare Advantage Plan on September 1, 2022.

Regardless of which MEA Benefits Trust plan you are on, if you are in an active course of treatment with a Fore River Urology doctor, please call Anthem customer service number on the back of your ID card and request "Continuity of Care". If you qualify for Continuity of Care, Fore River Urology will be treated as an in-network provider for a certain period of time.

Here are some important things to know ifyou choose to continue recieving care from Fore River Urology (FRU).

MEA Choice Plus & Standard Plans:

  • You may continue to receive benefits for covered services when you go to FRU, however the benefits will be paid at the self-referred level on Choice Plus and out of network level on Standard Plans.
  • FRU can charge you upfront for services and will require you to file your own claim with Anthem.
  • You can file an out of network claim with Anthem by using the "Claim Form" under the "Member" section of the MEABT website. www.meabt.org/documents. Instructions on how to complete the claim form and how to file your claim are included on the form. You can also file a claim by logging into Anthem's member portal, www.anthem.com. Once you are logged in, choose "Submit a Claim" under the "Claims and Payment" section located on the top of the page.
  • FRU can charge you for amounts over and above Anthem's allonwed amount. for example, if FRU charges $200 for an office visit and Anthem's allowance for that visit is only $150, you would be responsible for the $50 difference, as well as any dedcutible and coinsurance you may have under the plan.
  • There are other network urologists in the greater Portland area. To find an in-network provider, use the find Care tool on www.anthem.com or call Anthem's customer service at the phone number listed on the back of your ID card.
Medicare Advantage:
  • If you are enrolled on our Medicare Advantage plan, you can continue to see providers at Fore River Urology and you will be reimbursed 100% of the Medicare allowed amount for the covered services.
  • The MEA Benefits Trust Medicare Advantage plan provides 100% coverage for covered services regardless of wheter your provider is in or out of Anthem's network. The only requirement is for the provider to participate/accept Medicare.
  • Fore River Urology participates/acceps Medicare, and therefore cannot bill members for any amounts over the Medicare allowed amount.
  • As an out of network provider, Fore River Urology can require you to pay upfront for services and to file your own claim.
  • You can file an out of network claim with Anthem by using the "Claim Form" under the "Member" section of the MEABT website. www.meabt.org/documents. Instructions on how to complete the claim form and how to file your claim are included on the form. You can also file a claim by logging into Anthem's member portal, www.anthem.com. Once you are logged in, choose "Submit a Claim" under the "Claims and Payment" section located on the top of the page.
  • If FRU charges you upfront for services and above the Medicare allowed amount, once you've received reimbursement from Anthem for your claim, FRU will be required to refund you any amounts charged above the Medicare Approved Amount. For example, if FRU charges $200 for an office visit and Medicare's Allowed Amount for that visit is only $150, FRU would be required to refund you the $50 difference.
                -To obtain a refund for amounts charged over Medicare's allowed amount, you will need to bring your Anthem Explanation
                 Benefits, which outlines the claim payment, to FRU to request the refund.
  • There are other network urologists in the greater Portland area. To find an in-network, participating with Medicare provider, use the Find Care tool at www.anthem.com or call Anthem's customer service at the phone number listed on the back of your ID card.
  • We have tried to work with Fore River Urology directly and have asked them to coninue to file MEA Benefits Trust Medicare Advantage claims to Anthem, but they are unwilling to do so. You also may call Anthem customer service for assistance in filing an out of network claim.
If you have any questions regarding your coverage with Fore River Urology providers, please contact Anthem's customer service or the MEA Benefits Trust.