Carson Tahoe Regional Medical Center Frequently Asked Questions
Updated: May 20, 2021
Hometown Health’s contract terminates with Carson Tahoe Regional Medical Center effective June 30, 2021. Hometown Health has negotiated in good faith with Carson Tahoe Regional Medical Center and has offered a fair market value increase. However, Carson Tahoe Regional Medical Center has rejected our offer and is requesting an 84% increase for in-patient services, 6% increase for outpatient hospital services and a 20% increase for clinic services. Hometown Health’s main focus is to ensure that our members have access to high quality affordable care.
In preparation for the termination, we are proactively redirecting members care to either Carson Valley Medical Center, Renown South Meadows, Renown Regional Medical Center or another in-network provider.
Q. What Carson Tahoe Regional Medical Center entities are included in this termination?
• Carson Tahoe Regional Medical Center
1600 Medical Pkwy, Carson City
• Carson Tahoe Sierra Surgery – Carson Tahoe Breast Center, Imaging, Inpatient Services, Surgery
1400 Medical Parkway, Carson City
• Carson Tahoe Surgery Center – Pain Institute, Surgery
973 Mica Dr, Carson City
• Carson Tahoe Behavioral Health – Inpatient
1080 N Minnesota St, Carson City
• Carson Tahoe Cancer Center – Cancer Services
1535 Medical Parkway, Carson City
• Carson Tahoe Pain Institute
973 Mica Dr, Carson City
• Carson Mall – Urgent Care, Therapy
1201 S Carson St, Carson City & 1122 S. Stewart St, Carson City
• Carson Tahoe Dayton Medical Center – Carson Tahoe Medical Group, Outpatient Lab, Urgent Care
901 Medical Center Dr, Dayton
• Carson Tahoe Medical Group – Internal Medicine, Cardiology
10539 Professional Cir, Suite 200, Reno
• Carson Tahoe Medical Group – Midtown
412 W John St, Suite B, Carson City
• Carson Tahoe Medical Group – Multi Specialty clinic, Cardiology, Cardiac Rehab, Health & Wellness
1470 Medical Parkway, Suite 265 Carson City
• Carson Tahoe Medical Group – Internal Medicine
926 Incline Way, Suite 150, Incline Village
• Carson Tahoe Retail Clinic at Walmart
3200 Market St, Carson City, 3770 Topsy Lane, Carson City and 1511 Grant St, Gardnerville
• Eagle Medical Center – Carson Tahoe Great Basin Imaging, Carson Tahoe Medical Group, Carson Tahoe Diabetes Center, Carson Tahoe Rheumatology, Internal Medicine
2874 N Carson St, Carson City
• Carson Tahoe Specialty Medical Center – Carson Tahoe Continuing Care Hospital (LTAC), Center for Wound Healing Education Services, HealthCheck, Inpatient Behavioral Health Services, Outpatient Behavioral Health Services, Outpatient Lab
775 Fleischmann Way, Carson City
• Carson Tahoe MOM’s Clinic
1460 S. Curry St, Carson City
• Merriner Cottages
1555 Medical Parkway, Carson City
• Carson Tahoe Minden Medical Center – Cardiology, Carson Tahoe Medical Group, Emergent Care, Imaging, Internal Medicine, Lab Services, Oncology, Therapy
925 Ironwood Dr, Minden
Q. What products are affected by the termination?
A. Fully insured Commercial HMO, PPO, IFP, Senior Care Plus, Renown Health, Nevada Department of Corrections (NDOC), Peppermill, Caesars (ERI) and Washoe County Self-Funded plans. Certain Self-funded clients have a direct contract with Carson Tahoe Regional Medical Center and are not affected by this termination (Atlantis, City of Reno, City of Sparks, and Douglas County School District).
Q. How are members and providers notified of the contract termination?
A. Letters are being mailed to all providers and members on May 21, 2021.
Q. How will prior authorizations be managed prior to the termination date?
A. The UM team will be calling all providers that are submitting authorizations requests to re-direct the services to either Carson Valley Medical Center, Renown Health South Meadows, Renown Regional Medical Center or another in-network provider. The call script will be “Hometown Health’s contract is terminating with Carson Tahoe Hospital effective June 30, 2021. We received a prior authorization request for “Jane Doe” at Carson Tahoe Hospital and are calling to inquire if the services can be re-directed to another in-network provider or facility (Carson Valley Medical Center or Renown) to ensure that the members care is not interrupted.” If the provider refuses to redirect the authorization will be approved up to 6/30/2021. Any services as of 7/1/2021 will either be not covered or have a higher out of pocket cost based on the members plan.
Q. Will members that are receiving on-going medical care need to change from a Carson Tahoe Provider?
A. In order to ensure that members do not experience gaps in their care, HTH is proactively working to transition members from Carson Tahoe providers prior to the June termination date.
Q. What if the member or provider refuses to re-direct?
A. Members can continue to utilize Carson Tahoe provider’s in-network until June 30, 2021. Effective July 1, 2021, these providers will be out-of-network and will not be covered for HMO members and PPO members will be out-of-network. Hometown Health will work with the member and provider to help redirect their care to an in-network provider.
Q. How does a provider and/or a member re-direct their care?
A. The member and provider can search for providers at hth.dev.healthyusa.org or call Customer Service (SCP 775-982-3112 or (Commercial 775-982-3232).
Q. What if the member is unable to drive to the other facilities?
A. Hometown Health will cover transportation with UBER, or reimburse the member for an RTC bus pass or mileage reimbursement. If a member chooses reimbursement for an RTC bus pass or mileage reimbursement, please notify JoJo Tapia via email with the member number, member name, date of birth, home address, address for provider and appointment date. Mileage reimbursement will be based on a rate of $0.545 per mile from the member’s home to the provider office and back home.
