Grand River Medical group to end AmeriHealth Caritas contract

Published: Jul. 31, 2017 at 12:08 PM CDT
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Grand River Medical Group, PC leadership, has given AmeriHealth Caritas Iowa with a 90-Day Termination Notice to discontinue providing services to AmeriHealth Caritas Members.

Grand River Medical Group (GRMG) will continue seeing AmeriHealth Caritas Iowa Members through October 31.

This decision was made after many months of failed attempts to correct issues with the Managed Care Organization (MCO).

GRMG signed its contract with AmeriHealth Caritas Iowa in April of 2016.

Since then, it has been difficult to navigate the administrative processes with AmeriHealth Caritas, which has significantly impacted the ability for GRMG to provide healthcare services to AmeriHealth Caritas members.

Jodi Faustlin, CEO for GRMG, said, “Our goal is to provide high quality, timely healthcare services to every patient. As a result, after much consideration and dialogue with AmeriHealth Caritas representatives, terminating our relationship is the only course of action that allows us to reach this goal for our patients. We recognize the burden this change may place on our patients. However, we continue to have a contract with Amerigroup and will see patients with Amerigroup coverage should current AmeriHealth Caritas members choose to change their MCO carrier.”

The clinic has been working with the AmeriHealth Caritas Iowa team for several months to correct these issues, but they have not been successful.

Grand River Medical Group will be notifying its patients of this change over the next few weeks.

AmeriHealth Caritas patients make up about 1.8% of the clinics overall patient base or about 2,876 patients. GRMG will continue to see Members of AmeriHealth Caritas and Amerigroup MCOs until October 31.

Beginning November 1, GRMG will only see Members of Amerigroup MCO.

No other insurances will be affected by the change.

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