Most children who have been caught in a contract dispute between Santé Community Physicians and Valley Children’s Hospital can continue going to the hospital and to doctors who work there, a hospital spokeswoman said Tuesday.
The hospital and Specialty Medical Group Central California have arrangements with three insurance companies — Anthem Blue Cross, Blue Shield and United Healthcare — to see children who have HMO health plans through Santé, said Valley Children’s spokeswoman Zara Arboleda.
The deals with Anthem, Blue Shield and United Healthcare cover about 90% of the children who have plans with Santé, she said.
The hospital and Specialty Medical Group are in negotiations with Aetna, Cigna and Health Net. Patients with those plans may be referred out of the area for pediatric specialty care, she said.
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But for most families, arrangements are in place to avert a Thursday deadline that threatened to cut off children from care at the hospital. Specialty Medical Group and Valley Children’s Hospital said in October that they were ending contracts with Santé, the largest doctors’ group in Fresno with about 1,200 physicians and other health providers. Specialty Medical Group said it would no longer see Santé patients after Thursday.
On Monday, Dr. Daniel Bluestone, Santé’s medical director, said he was confident children would be seen. “We’ve conferred with each of the health plans and they’ve conferred with the hospital and there is a mechanism in place where kids who really need care at Children’s can get it.”