New Blue HPN® plans in effect
When you understand your patients’ health coverage and local health plan networks, you can help maximize your patients’ benefits and boost your own success. Here are some details you should know about new Blue HPN products and the high performance network in Virginia:
Blue HPN® plans offer access to a select set of providers with a record of delivering high-quality, efficient care. Blue HPN networks are live, effective January 1, 2021, in more than 50 cities across the country.
In Virginia, Blue HPN networks are in place in the Richmond and the Washington, D.C-Arlington-Alexandria metro areas. Virginia-based employers of all sizes may offer plans with access to the local HPN, referred to as the Blue Connection network.
The Virginia Blue Connection network is a closed narrow network by design. If you are a participating professional provider, please note that only those provider offices that are physically located within the designated metro areas (as determined by ZIP code) will be considered in network. If your organization has multiple office locations, only those locations in the Blue Connection ZIP codes will be considered in-network. Certain exceptions may apply for Ancillary providers (for example Ambulance, Dialysis, Infusion Therapy and so on).
A special note for our professional providers located in the northern Virginia Anthem/CareFirst service area: Participation in the Anthem Blue Connection network is based on the physical office location’s nine-digit ZIP code.
You can search our Find a Doctor/Find Care tool at www.anthem.com to find participating HPN providers effective January 2, 2021. If you have questions about your participation status, please contact your Anthem Network Manager.
You may see patients accessing this network through either a national employer plan, Blue HPN, or large or small group employer EPO plans and HSA plans with EPO network. Under EPO plans, out-of-network benefits are limited to emergency or urgent care. Members may be required to select a primary care provider (PCP), but PCP referrals are not required for specialty care.
Large group BlueHPN health plans sold in Virginia have a plan prefix of H8V, and small group plans prefixes include H9V and H5V. Keep in mind that other prefixes may be part of HPN plan member IDs. The new “Blue High Performance Network” logo and “HPN” indicator in the suitcase icon are the most reliable indicators that a member is enrolled in an HPN plan.
The above SAMPLE Virginia ID card is for illustration purposes only.
January 2021 Anthem Provider News - Virginia