Nurse practitioners eligible to be listed as primary care provider

Nurse practitioners are recognized in Ohio state policy as primary care providers that may provide preventive and primary care services, provide services for acute illnesses, and evaluate and promote patient wellness within the nurse’s nursing specialty, consistent with the nurse’s education and certification. In an effort to expand access to primary care services, Anthem Blue Cross and Blue Shield (Anthem) in Ohio will begin allowing nurse practitioners collaborating with primary care physicians or primary care physician groups, to be set up in our system as primary care providers, available for selection by members participating in applicable plans.

 

We are conducting a review of our provider data and will be making this change for nurse practitioners we are able to identify as collaborating with a primary care physician. The determination for this designation will be made separately for each contracted group a nurse practitioner might be listed with in Anthem’s database. 

 

To support this change in our Participating Provider Agreements, the obligations of Health Professional Practitioners in your Participating Provider Agreement shall be updated to memorialize this expansion of primary care services. Notification of this change to your Agreement will be sent separately.

 

If your practice employs nurse practitioners that support primary care physicians, and you do not want the nurse practitioners in your practice to be designated as primary care providers available for member selection, please contact your local Provider Solutions office at Ohio_Provider_Solutions@anthem.com to let us know. 

 

1299-0921-PN-OH