Prevea Health

Anthem FAQ

A message from Ashok Rai, MD
President & CEO of Prevea Health
Thank you for visiting our page dedicated to keeping you informed about the relationship between Prevea Health, HSHS hospitals in Eastern Wisconsin (HSHS St. Vincent Hospital and HSHS St. Mary’s Hospital Medical Center in Green Bay; HSHS St. Nicholas Hospital in Sheboygan; HSHS St. Clare Memorial Hospital in Oconto Falls) and Anthem Blue Cross and Blue Shield (Anthem).


*Updates about the status of negotiations with Anthem will be posted here.

As of Feb. 10, 2020:
Prevea Health and HSHS hospitals in Eastern Wisconsin are currently in active negotiations with Anthem regarding a new contract and rates.
Recently, Anthem sent notice of termination of the agreement with Prevea Health and HSHS hospitals in Eastern Wisconsin with an effective date of March 1, 2020.
Prevea Health and HSHS are working diligently and in good faith with Anthem to reach an agreement prior to the termination date so our Anthem patients can continue to receive care in our hospitals and health centers while also remaining in-network.
We remain in contact with Anthem on a daily basis in an effort to reach a successful agreement as quickly as possible.



When did negotiations between Anthem, Prevea Health and HSHS hospitals in Eastern Wisconsin begin?
Prevea Health, HSHS hospitals in Eastern Wisconsin and Anthem have partnered in providing health care and access to health care in Eastern Wisconsin for more than 20 years. We negotiate a new agreement about every three years, which is standard practice. Our most recent negotiations began in late 2019.
Why hasn’t an agreement been reached?
Our patients come first and it is important we make sure all terms in the agreement with Anthem allow us to provide our Anthem patients with the highest quality of care, while also ensuring the sustainability of our health centers and nonprofit hospitals that serve the health care needs of so many in communities big and small throughout the region. Currently, there are some terms included in Anthem’s proposal that leave us feeling uncertain and we are actively seeking clarification on what those terms mean so we can work quickly toward an agreement.
What will happen if an agreement is not reached prior to March 1, 2020?
If we are not able to reach a successful agreement prior to March 1, our providers will become out of network for all Anthem members with commercial HMO, PPO and POS health plans as well as Medicare Advantage and Medicaid health benefit plans offered by Anthem.  Medicare supplement policies would not be impacted.
How will you keep me informed and updated on this situation?
We will provide updates on this page and also be sure to send you a letter in the mail regarding any important updates.
Is there someone I can speak to about my questions or concerns?
We have set up a phone line dedicated to our Anthem patients. Please contact us at (920) 272-3500.
You can also contact Anthem at the customer service number on the back of your insurance card to let them know you wish to remain in-network with Prevea Health and the HSHS hospitals in Eastern Wisconsin.
In addition, you may consider speaking with your employer about other plan options that would allow you to have in-network access to our hospitals and health centers.