Blue High Performance Network

Blue High Performance Network^SM (BlueHPN^SM) plans offer access to providers with a record of delivering high-quality, efficient care. Since January 2021, we’ve been collaborating with select healthcare providers across the U.S. to make BlueHPN available to members. Anthem’s mission is to provide affordable, quality healthcare benefits to its members. This in-network only plan helps keep members’ healthcare costs more predictable and manageable.

It is important to know that only in-network care is covered in the BlueHPN. Members in the BlueHPN cannot go to out-of-network doctors or hospitals, except in an urgent and/or emergent situation. If they see a provider for routine or non-urgent care outside the BlueHPN, they will not have coverage.

If you are not participating in the Blue Connection network, you are also not participating in the BlueHPN.

Recognizing BlueHPN members

You and your staff can identify patients enrolled in BlueHPN plans by their member ID card. The BlueHPN name will be prominently displayed on the front of the member ID card, along with the BlueHPN suitcase logo, as shown below:

Eligibility and benefits

BlueHPN does not offer coverage for out-of-network care with the exception of urgent and/or emergent services. This means that BlueHPN patients will receive full benefits from in-network BlueHPN providers.

You can check BlueHPN plan member eligibility and benefits the same way you do today for Blue Connection members — Either submit a HIPAA 270 eligibility and benefit request transaction or contact Provider Services at the number on the back of the member’s ID card.

Referrals to BlueHPN providers

BlueHPN is a comprehensive network that includes a full range of providers, from primary care doctors and specialists to hospitals. Not all healthcare providers are included. To ensure your BlueHPN patients will have full benefits when they need to see a specialist or another healthcare provider, it’s important that you only recommend other BlueHPN healthcare providers. You can use the Find a Doctor/Find Care tool at https://anthem.com/find-care to identify BlueHPN healthcare providers by searching by the member’s ID or alpha prefix. This will help ensure your patients will be receiving care from healthcare providers who are also committed to providing high quality, cost-efficient care. Please make sure you and your office staff are checking network status when referring members to new providers.

Formal physician-to-physician referrals are not required under BlueHPN plans, but out-of-network benefits are limited to urgent and/or emergent services only. That means referrals for non-emergency care to providers outside the BlueHPN network, including durable medical equipment and laboratory services, may be costly for your patients.

Additional network information

More than 60 large metropolitan areas have their own high-performance networks sponsored by local Anthem plans across the country, which gives national employers access to high quality, cost-efficient providers in these geographic areas. The Ohio BlueHPN uses the existing Blue Connection network; therefore, you may see both local patients who have access to Blue Connection through the Anthem plan and patients traveling from other cities where BlueHPN products are offered. Ohio-based employer-sponsored health plans with access to our Ohio High Performance Network refer to the BlueHPN as Blue Connection.

If you are not sure whether your practice is part of the Ohio BlueHPN or Blue Connection, ask your office manager or business office or contact your provider relationship account manager.