Provider Central

How do I identify an Access Blue or Access Blue New England member?

• Their member ID number will begin with one of the following three-letter prefixes:
  • XXF
  • XXT

• Their member ID number will begin with one of the following three-letter prefixes based on their home plan:
  • Massachusetts: EHJ
  • Connecticut: EHF
  • Maine: EHG
  • New Hampshire: EHH or BPP

Which providers can these members see?

• Members can use any provider in our HMO Blue network, without the need for a referral.

• Members can use any provider in our HMO Blue New England network, including participating providers in all New England states, without the need for a referral.

Do these members need to have a primary care provider (PCP)?

• We recommend that the member chooses a PCP, but it is not required.

• The member must choose a PCP from any of the six New England states:
  • Connecticut
  • Maine
  • Massachusetts
  • New Hampshire
  • Rhode Island
  • Vermont

Are referrals and authorizations required?

• No referrals are required.
• Authorization is required for inpatient admissions.
• Certain outpatient services require authorization.

• No referrals are required.
• Authorization requirements are determined by the state where the PCP participates, except mental health services which are determined by the home plan.
• For members with a Massachusetts PCP, certain outpatient services require authorization.