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Uniform Glossary of Terms »
Provider Networks

Participating

The Participating (Traditional) Network is the largest Regence BCBSU network and supports all traditional and indemnity products. Physicians, other health care professionals and facilities (providers) must participate with this network to be eligible to participate with any other Regence BCBSU network.

Preferred

Three Preferred networks, Preferred BlueOption Network, Preferred ValueCare Network and Preferred FocalPointSM Network, offer our members greater choice in providers while receiving the highest benefit levels.

These Preferred networks support members on the following group and Individual products:

Employer Group Products

Products

Preferred Network Options
 
BlueOption
ValueCare
FocalPoint
BluePoint
X
X
X
Engage®
X
X
Not available
Innova®
X
X
Not available
HSA Healthplan 2.0SM
X
X
Not available
HSA Healthplan 3.0SM
X
X
X

Individual and Family Products

Products

Preferred Network Options
 
BlueOption
ValueCare
FocalPoint
Evolve CoreSM
Not available
X
Not available
Evolve Core 2.0SM
X
X
X
Evolve HSASM
Not available
X
Not available
Evolve HSA 2.0SM
X
X
X
Evolve HSA 100SM
Not available
X
Not available
Evolve HSA 100 2.0SM
X
X
X
RealValueSM
Not available
X
X
Individual Metallics
Not available
X
X

Preferred BlueOption

The following hospitals are included in the Preferred BlueOption Network:

Preferred BlueOption Network Hospitals

Allen Memorial Hospital  Fillmore Hospital Orem Community Hospital
Alta View Hospital Garfield Memorial Hospital Park City Medical Center
American Fork Hospital Gunnison Valley Hospital Primary Children’s Medical Center
Ashley Regional Medical Center Heber Valley Medical Center Riverton Hospital
Bear River Valley Hospital Intermountain Medical Center  San Juan County Hospital
Beaver Valley Hospital Kane County Hospital Sanpete Valley Hospital
Castleview Hospital  LDS Hospital Sevier Valley Medical Center
Central Valley Medical Center Logan Regional Hospital The Orthopedic Specialty Hospital 
Davis Hospital and Medical Center McKay-Dee Hospital Uintah Basin Medical Center
Delta Community Medical Center Milford Valley Hospital Utah Valley Regional Medical Center
Dixie Regional Medical Center Mountain West Medical Center Valley View Medical Center

Preferred ValueCare

In addition to group and Individual products, Preferred ValueCare is also the Preferred network for Federal Employee Program (FEP) and BlueCard® members.

  • FEP members should utilize the ValueCare Network as their Preferred network for providers, as well as for non-hospital facility services for their highest benefit. All hospitals in the state are available to FEP members at their highest benefit level.
  • BlueCard® members with a “PPO in the suitcase” icon on their member card should utilize providers and hospitals in the ValueCare Network for their highest benefit. BlueCard members with a blank suitcase may receive services from any Participating provider or hospital in the state. Note: For dates of service on or after January 1, 2014, claims for BlueCard PPO members (members with a PPO in the suitcase) will be paid at non-participating benefit levels for the following urban facilities (Alta View Hospital, American Fork Hospital, Intermountain Medical Center, LDS Hospital, McKay-Dee Hospital, Orem Community Hospital, Riverton Hospital, The Orthopedic Specialty Hospital, Utah Valley Regional Medical Center) or one of these surgical centers (Avenues Surgical Center, McKay-Dee Surgical Center). Please make a note of these changes if you ordinarily refer patients to these facilities, or if your practice includes these facilities.

The following hospitals are included in the Preferred ValueCare Network table:

Preferred ValueCare Network Hospitals

Ashley Regional Medical Center Gunnison Valley Hospital Park City Medical Center
Bear River Valley Hospital Heber Valley Medical Center Primary Children’s Medical Center
Beaver Valley Hospital Huntsman Cancer Hospital

Riverton Hospital Children’s Unit (not Riverton Hospital)

Blue Mountain Hospital Jordan Valley Medical Center - West Jordan and Pioneer Campuses Salt Lake Regional Medical Center
Brigham City Hospital Kane County Hospital San Juan County Hospital
Cache Valley Specialty Hospital Lakeview Hospital Sanpete Valley Hospital
Castleview Hospital  Lone Peak Hospital Sevier Valley Medical Center
Central Valley Medical Center Logan Regional Hospital St. Marks Hospital
Davis Hospital and Medical Center Milford Valley Hospital Timpanogos Regional Hospital
Delta Community Medical Center Moab Regional Hospital Uintah Basin Medical Center
Dixie Regional Medical Center Mountain View Hospital University of Utah Hospitals and Clinics
Fillmore Hospital Mountain West Medical Center University of Utah Orthopedic Center
Garfield Memorial Hospital Ogden Regional Medical Center Valley View Medical Center

Preferred FocalPoint

Regence, MountainStar, the University of Utah and targeted providers who refer the majority of their members to MountainStar and the University of Utah providers, have partnered to create this focused network. This network is by invitation only.

FocalPoint is geographically centered along the Wasatch Front with facilities from Brigham City to Payson. The following hospitals are included in the Preferred FocalPoint Network:

Preferred FocalPoint Network Hospitals

Brigham City Hospital Ogden Regional Hospital University Neuropsychiatric Institute
Huntsman Cancer Institute Primary Children's Medical Center University of Utah Hospital
Lakeview Hospital St. Mark's Hospital University Orthopedic Center
Mountain View Hospital Timpanogos Regional Hospital  

Learn more about Preferred FocalPoint.

Regence MedAdvantage PPO

Our Regence MedAdvantage PPO products use the Regence BlueCross BlueShield of Utah MedAdvantage Network for in-network services with no referral requirements to access specialty care. Regence MedAdvantage provides all Part A and B benefits with additional covered services in one plan.

The Regence MedAdvantage service area includes Box Elder, Cache, Davis, Iron, Morgan, Rich, Salt Lake, Summit, Tooele, Utah, Wasatch, Washington and Weber counties in Utah.

Regence BlueAdvantage HMO

Our Regence BlueAdvantage HMO product uses the Regence BlueCross BlueShield of Utah Medicare Advantage HMO Network for in-network services and requires referrals to access specialty care. BlueAdvantage HMO provides all Part A and B benefits with additional covered services in one plan.

The BlueAdvantage HMO service area includes Davis, Salt Lake, Utah and Weber counties in Utah.

Dental Networks

Participating Dental

The Participating Dental Network serves our members enrolled in our participating fee-for service dental plans in Utah. Participating dentists are reimbursed according to our maximum allowable fee schedule. Payments and a remittance statement (which explains payment for services provided to our members) are sent directly to participating dental offices each week.

Preferred Dental

The Preferred Network serves members covered under the Federal Employee Program (FEP). Payments and remittance advices (voucher explaining payment for services provided to our members) are sent directly to contracted dental offices each week.

 

 

 

 

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