This article is for medical providers caring for our members
In 2022, membership is increasing in plans that use the newest national limited network, the Blue High Performance NetworkSM (BlueHPNSM). Working with other Blue Plans, this network can be paired with Exclusive Provider Organization (EPO) plans for coverage across the U.S. For more information about the BlueHPN, see our Limited Networks page.
In Massachusetts, we’re enrolling members in Advantage Blue Performance plans that pair with the BlueHPN limited network. Since you may start seeing more of these patients in 2022, here’s more information to help you recognize them.
How does an EPO plan work?
Members will need to choose BlueHPN providers for their care. EPO benefits are limited to emergency care at a hospital facility only when performed by non-BlueHPN providers.
How can I identify members who use the Blue HPN network?
As shown in the sample ID card below, you can easily recognize patients with this plan by the:
- Network name “Blue High Performance Network”
- “BLUEHPN” in a suitcase logo on the front of the member ID card
How to verify member benefits and eligibility through our Provider Central website
As always, we recommend checking patient eligibility and benefits before providing services. You can do this using ConnectCenter™, which will replace Online Services in 2022, or you can use another similar technology.
How do I know if I’m in the BlueHPN network?
To develop this network, we followed the same methodology used to determine the existing Blue Select network and applied it to all providers in Bristol, Essex, Middlesex, Norfolk, Plymouth, and Suffolk counties.
You can use our Find a Doctor & Estimate Costs tool to check your participation in the BlueHPN.
- Choose Select your network to continue (not logged in)
- In the drop-down of network choices, choose Blue High Performance Network (see example below)
Where do I submit claims?
You’ll follow the same claims filing procedures you use today for BlueCard® PPO patients.
Resources
These pages will be refreshed on January 1, 2022 when plans become effective.
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