Elkhorn Valley Family Medicine

04/17/2025

EVFM will be closing early at 3pm on Friday, April 18th for Easter.

12/01/2024

In 2019, CVS determined it had saved more than $600 million the previous year by denying prior authorization requests its Medicare Advantage beneficiaries submitted for inpatient facilities. A majority of these savings came from denied admissions.

10/22/2024

84% of Nebraska hospitals report it is more difficult to get post-acute placements approved for Medicare Advantage patients than traditional Medicare patients.

10/18/2024

The Medicare enrollment period is October 15 - December 7. Health care emergencies can happen. Does your plan make you wait for care or deny it? Know the facts about Medicare Advantage and consult your provider before you enroll or switch.

Read the full report here: https://loom.ly/DkBuG38

10/18/2024

Elkhorn Valley Family Medicine has made the difficult decision to no longer accept BCBS Medicare Advantage effective January 1st, 2025. This means we will no longer submit claims to BCBS Medicare Advantage. If you have BCBS Medicare advantage you will be responsible to submit your claim for our services and you will be responsible for payment.

We have experienced considerable delays and difficulties in providing patient care due to the prior authorization process required by BCBS Medicare Advantage. We have also experienced inappropriate denials of care which result in unacceptable delays as their appeals processes are long and complicated. This affects our ability to provide comprehensive and state of the art care to you, our patients.

Medicare Advantage plans (Medicare Part C) should not be confused with traditional Medicare (Parts A, B, and D). They are very different even though the funding for both are through the payments you have provided throughout the years to the Medicare Trust fund. Medicare Advantage plans are administered by private insurance programs for their profit whereas traditional Medicare is not. Medicare Advantage plans require prior authorization for several diagnostic services such as CT scans, MRI scans, sleep studies, PET scans, Holter/Event monitors, stress tests, and some laboratory tests. Many procedures such as pain injections, cardiac catheterizations and surgery also must be prior authorized before they can be scheduled. Copays are quite common for medications, tests/services of all types, consultations, and even some office visits. Traditional Medicare has none of those constraints and is accepted throughout the entire USA whereas Medicare Advantage plans are regional.

Please note, currently there are several facilities in Nebraska that are no longer accepting some or all Medicare Advantage plans. We have been notified all Avera facilities are no longer accepting Humana Medicare Advantage. Recently, the Nebraska Hospital Association issued a report detailing how Medicare Advantage is “failing patients and jeopardizing Nebraska hospitals.” The report cites negative patient experiences, placement delays, administrative issues, and financial burdens on hospitals which accept Medicare Advantage patients. Therefore, we advise all patients with any Medicare Advantage plan to carefully review their healthcare plan and ensure all the providers and facilities they use accept the plan they have chosen. We remind everyone that open enrollment will start on October 15 and runs through December 7. If you become dissatisfied with the plan you have chosen in the open enrollment period within the first 3 months, there are certain circumstances which allow you to change plans. Otherwise, you cannot change plans until the next open enrollment period. And, also realize that once you have left traditional Medicare, if you choose to return to traditional Medicare, your supplement insurance may have restrictions (if more than one year has passed) on pre-existing conditions.

10/07/2024

10/07/2024

UPDATE: West Holt Memorial Hospital remains a place for emergent deliveries only. Avera St. Anthony's staff has been recalled, but the necessary equipment remains in Atkinson. The two hospitals are working through contract negotiations to share staff.

For more information, please contact the EVFM clinic or monitor our page.

UPDATE: Late this afternoon, the state informed us only emergent deliveries can be done in Atkinson due to West Holt Memorial Hospital not being certified for obstetrics. All of the necessary equipment from Avera St. Anthony's remains at West Holt Memorial Hospital, as well as staffing by OB nurses from St. Anthony's. This may change daily.

For more information, please contact the EVFM clinic or monitor our page.

EVFM OB Patients: If you need to go to the hospital, please go to the West Holt Memorial Hospital in Atkinson until Avera St. Anthony's Obstetrics is open again. All necessary equipment has been moved to accommodate obstetric patients, as well as staffing.

For more information, please contact the EVFM clinic or monitor our page.

10/07/2024

🚨 **IMPORTANT NOTICE** 🚨

Avera St. Anthony’s Hospital is currently setting up a modified Emergency Room at the O'Neill Community Center.

🔴 **In case of a 911 emergency, please call 911 immediately.**
🔹 For non-emergency medical assistance, please visit the O’Neill Community Center for care.
🔻 **Emergency patients are being diverted to neighboring hospitals.**

If you have been evacuated due to the explosion and need a place to go, the O'Neill Community Center is open for shelter. Stay safe, O'Neill, and follow local updates for more information. 'Neill

10/07/2024

EVFM will be opening at 1pm today, October 7th.

09/04/2024

Dr. Fenske will be out of the office Monday, September 2nd through Friday, September 6th. He will return to the office on Monday, September 9th.

Call the office to schedule ahead if needed!
📞402-336-4222

09/04/2024

Phones are back in service