Important Changes Regarding Valley Health
Our members’ healthcare is important to us and one of our goals is to keep you informed about changes that could affect them.
Valley Health System hospitals, PCPs, and specialists—located in the Shenandoah region—will no longer be covered in network under Optima Health benefits for care received after December 31, 2021, for commercial and Medicare members.
Optima Health members who have received services through terminating facilities, PCPs, or specialists will receive a 30-day notification by December 1.
Alternative Hospital Options
We are committed to finding mutually agreeable contract terms and ensuring no disruption to the services. Optima Health contractual relationships with other facilities and providers are not impacted. To find other providers in the Optima Health network, members can look online at optimahealth.com/findadoc. Please note, Valley Health System hospitals will still display as in-network in the provider directories up until the termination on December 31.
Changes in Coverage
Members can continue to use all Valley Health System facilities and providers with no change in coverage until December 31, 2021.
Unless in emergent situations starting January 1, 2022, members on HMO plans will no longer have coverage for Valley Health System hospitals and providers. PPO and POS members accessing services from Valley Health System hospitals and providers will do so under their out-of-network benefit, which will result in a higher out-of-pocket cost.
Transition of Care
Our case management team will follow our standard transition of care protocols for members with approved prior authorizations, in their second or third trimester of pregnancy, in active treatment for chronic or acute medical conditions, or with hospitalizations. We have identified members who have accessed services through an impacted Valley Health System facility or provider; we will notify and work with these members to find appropriate in-network alternatives for their care, if necessary.
Please let us know if we can be of any assistance. We value your partnership and look forward to serving you in the months and years to come.