New York
Provider Communications

Dec 1, 2018 • Administrative

Empire will introduce a new provider network effective January 1, 2019. This new network is called “Blue Access” and will be a limited network of providers.  Providers who are currently participating in the Pathway network will also be participating in the new Blue Access network.  A letter was sent to all providers who are participating in the Blue Access Network.  For questions about your participation status contact your network management coordinator.  Please note the reimbursement for the Blue Access Network will be  at the current Small Group rate.

 

Empire members that are covered under a benefit plan that utilizes the Blue Access network will have member ID cards that read “Blue Access” at the top of their member ID card. If you are included as a provider in the Blue Access network, it is important for you to understand that this is a limited provider network. Benefit plans offered on the Blue Access network will not cover out of network providers services; therefore, please confirm a provider’s participation status with Empire’s Find a Doctor tool found on empireblue.com prior to referring to or scheduling services with another provider.

 

Only participating Blue Access providers should be used for Empire members that are covered under a benefit plan that uses the Blue Access network. Should a non-participating provider be required, Empire’s Use of a Non-Participating Provider Advance Patient Notice Policy will apply. As a reminder, Empire’s Advance Patient Notice form can be found at empireblue.com. Failure to refer patients to a participating provider could result in increased out of pocket costs for our members.

 

Small Group Health Benefit Plans utilizing the Blue Access network:

 

Product	Network Name	Medical Product Type	Small Group Health Benefit Plans Description	BCA Prefix
Small Group	Blue Access	EPO	Empire Bronze Blue Access EPO Empire Gold Blue Access EPO Empire Platinum Blue Access EPO Empire Silver Blue Access EPO	YXE
Small Group	Blue Access	Gatekeeper EPO	Empire Bronze Blue Access GEPO* Empire Gold Blue Access GEPO* Empire Platinum Blue Access GEPO* Empire Silver Blue Access GEPO*	XNU
Small Group	Blue Access	HSA-HMO	Empire Bronze Blue Access HMO* Empire Gold Healthy New York Blue Access HMO*	YXC YXD

*PCP and Referrals required

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Featured In:
December 2018 Empire Provider Newsletter