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Preferred (BlueOption) Network
Frequently Asked Questions

  1. What is the new network?
    The new network name is Preferred BlueOption. It joins our existing Utah networks— Preferred ValueCare and Participating (formerly known as Traditional).

  2. When will the new network be available?
    The Preferred BlueOption Network became available for employer groups to select beginning January 1, 2010.
     
  3. Why is Regence adding a new network?
    In 2010, we began transitioning employer groups from our standard health plan products (Traditional and ValueCare) to our self-managed and consumer directed health plan products (Regence Innova®, Engage®, ActivateSM, HSA Healthplan 2.0SM and others as they are added). Employers can now choose which of the two Preferred networks will best meet the needs of their group for Category 1 benefit levels.

  4. What is the advantage of two Category 1 choices?
    Having two Preferred networks allows Utah members to seek services from their choice of providers while taking advantage of the out‑of‑pocket savings associated with receiving services at Category 1 benefit levels. Over 93% of physicians or other health care professionals in Utah are included in Preferred networks. Additionally, all of the hospitals in the state participate in the Preferred BlueOption Network or the Preferred ValueCare Network; many participate in both Preferred networks.

  5. Does the Preferred BlueOption Network replace the Preferred ValueCare Network?
    No. The Preferred BlueOption Network is in addition to the Preferred ValueCare Network. BlueOption is available to groups who purchase one of our self-managed and consumer directed products. The Preferred ValueCare Network continues to be available for members enrolled in the self-managed and consumer directed products, as well as members enrolled in our current ValueCare health plan product.

    Federal Employee Program (FEP) members continue to utilize the ValueCare Network as their Preferred network for physicians and other health care professionals, as well as for non-hospital facility services. All hospitals in the state are available to FEP members at their highest benefit level.

    BlueCard (PDF) members with a “PPO in the suitcase” icon on their member card continue to 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.

  6. What hospitals are included in each Preferred network?
    All Utah hospitals are included in one or both Preferred networks. The charts below illustrate the Preferred network(s) with which each hospital participates.

    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 Network Hospitals

    Allen Memorial Hospital  Gunnison Valley Hospital Primary Children’s Medical Center
    Ashley Regional Medical Center Heber Valley Medical Center Salt Lake Regional Medical Center
    Bear River Valley Hospital Huntsman Cancer Hospital San Juan County Hospital
    Beaver Valley Hospital Jordan Valley Medical Center Sanpete Valley Hospital
    Brigham City Hospital Kane County Hospital Sevier Valley Medical Center
    Cache Valley Specialty Hospital Lakeview Hospital St. Marks Hospital
    Castleview Hospital  Logan Regional Hospital The Orthopedic Specialty Hospital 
    Central Valley Medical Center Milford Valley Hospital Timpanogos Regional Hospital
    Davis Hospital and Medical Center Mountain View Hospital Uintah Basin Medical Center
    Delta Community Medical Center Mountain West Medical Center University Hospital
    Dixie Regional Medical Center Ogden Regional Medical Center University of Utah Orthopedic Center
    Fillmore Hospital Park City Medical Center Valley View Medical Center
    Garfield Memorial Hospital Pioneer Valley Hospital  

  7. How will members and providers know whether the selected Preferred network is the ValueCare or BlueOption Network?
    The Preferred network designated to provide access to Category 1 benefit levels will be displayed on the member card above the health plan product name.
    Note: The product name will not be displayed if the member’s group has purchased a customized version of one of these products.

    Member card showing ValueCare or BlueOption network

  8. If a group chooses BlueOption as its Preferred Provider Network choice, do the benefits change?
    No. Benefits will remain the same for Innova, Engage, Activate and HSA Healthplan 2.0 health plan products.

  9. How will this affect BlueCard and FEP members?
    The Preferred BlueOption Network does not apply to the BlueCard Program or to the Federal Employee Program (FEP).

    BlueCard members with a “PPO in the suitcase” icon on their member card continue to 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.  

    FEP members continue to utilize the ValueCare Network as their Preferred network for physicians and other health care professionals, as well as for non-hospital facility services. All hospitals in the state are available to FEP members at their highest benefit level.

  10. Does this impact Regence MedAdvantage members?
    No. Regence MedAdvantage members continue to access the Regence MedAdvantage Network of providers.

  11. What should a provider’s office staff be aware of?

    Offices can identify members on these products by the colorful background designs on their member cards. Designs include the member’s choice of: a snowboarder image, one of four cityscapes (Boise, Portland, Salt Lake City or Seattle) or one of two graphic designs (diamonds or circles). Typically, one of the following health plan product names will be displayed on the member card: Innova, Engage, Activate or HSA Healthplan 2.0. The Preferred BlueOption network is not available on any other health plan product.

    Note:  The product name will not be displayed if the member’s group has purchased a customized version of one of these products.

    The Preferred network selected to provide access to Category 1 benefit levels (BlueOption or ValueCare) will be displayed on the member card above the health plan product name (except in the case of custom products as noted above).

    Office visit copayment amounts and the number of up-front visits will be included on the member card, if applicable.


  12. What if a member is in her last trimester of a pregnancy when her employer group changes its choice of Preferred networks to the Preferred BlueOption Network, and the member’s doctor will not deliver at one of the BlueOption Network hospitals?
    Hospital affiliation is a personal consideration each provider must make. Members may receive services at any hospital; however, if the provider does not practice at a hospital in the member’s Preferred provider network, members will not receive Category 1 benefit levels under their health plan. The member will need to choose whether to retain her current physician and received benefits for the services at a Category 2 or Category 3 level, or select a provider who does practice at a hospital in the member’s Preferred Provider Network. We are asking providers to advise members of their affiliated hospital’s network, but it is primarily the member’s responsibility to be aware of his or her benefits and network options.

View hospitals in the Preferred BlueOption Network
View hospitals in the Preferred ValueCare Network

  1. What about continuation of care considerations? What if a member is in the hospital at the time of the network change (i.e., member is admitted to a Preferred network hospital on December 28, with care continuing past January 1, but the employer has selected a different Preferred network effective January 1)?
    Because of the change in designated Preferred network, the hospital claim must be split – one claim for dates of service prior to January 1 and another claim for dates of service beginning January 1. The claim for services received prior to January 1 will be processed at the Category 1 benefit level; the claim for services received on January 1 through discharge will be processed at the Category 2 or Category 3 benefit level.

  2. Will physicians or other health care professionals (professional providers) need to sign a BlueOption addendum?
    The current Preferred addendum applies to both Preferred networks so, generally, no additional contracting is needed for professional providers. Our Network Development team has identified and will be contacting those professional providers that will need to sign a new addendum.

  3. How will benefits be administered if a Preferred professional provider sends lab work to the hospital they are affiliated with, but the hospital is not in the patient’s selected Preferred network?
    Services rendered and billed by the Preferred provider will be paid at the Category 1 benefit level, but any lab services which that provider sends to a facility not participating in the patient’s selected Preferred network will be paid at the Category 2 or Category 3 benefit level. Any other services billed by the facility, such as radiology or pharmacy will also be processed at Category 2 or Category 3 benefit levels. This will result in the patient paying higher out-of-pocket costs. We urge providers in this situation to be aware of what facilities are available for Category 1 benefit levels for these adjunct services.
  1. Where can we find additional information?
    Learn more about the Preferred BlueOption Network—including links to the updated Regence Innova, Engage, Activate and HSA Healthplan 2.0 online workshop and affected Administrative Manual sections.

  2. Who should we contact if we have additional questions about the Preferred BlueOption Network?
    Contact Provider Customer Service for Innova, Engage, Activate and HSA Healthplan 2.0 products at 1 (877) 417‑6222 or you may contact your provider consultant.

 

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