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 (Traditional).
   
   
2. When will the new network be available?
   The BlueOption network will be available for employer groups to select beginning January 1, 2010.
    
3. Why is Regence adding a new network?
   In 2010, we will begin transitioning employer groups from our standard products (Traditional and ValueCare) to our self-managed and consumer directed products (Regence Innova^®, Engage^®, Activate^SM, HSA Healthplan 2.0^SM and others as they are added). This new network provides employers with two Preferred networks to choose from, based on the needs of their group, to receive Category 1 benefit levels.
   
   
4. What is the advantage of two Category 1 choices?
   Combined, these two networks encompass over 93% of the providers and 100% of the hospitals in the state. This 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.
   
   
5. Will the BlueOption network replace the ValueCare network?
   No. The BlueOption network is in addition to the ValueCare network. BlueOption is available to groups or Individuals who purchase one of our self-managed or consumer directed products. The ValueCare network will continue to be available for members enrolled in these products, as well as members enrolled in our current ValueCare product.
   
   Federal Employee Program (FEP) members will 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 Preferred benefit level.
   
   BlueCard members with a “PPO in the suitcase” icon on their member card will 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 chart below illustrates the Preferred network(s) with which each hospital participates.
   
   

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

   
   
   
7. How will members and providers know whether the selected Preferred network is the ValueCare or BlueOption network?
   If the BlueOption network is chosen, BlueOption will be printed on the member card above the product name. Currently, if ValueCare is chosen, the member card will display the product name only.
   
   
   
   
8. If a group chooses BlueOption as the Category 1 network choice, do the benefits change?
   No. Benefits will remain the same for Innova, Engage, Activate and HSA Healthplan 2.0 products.
   
   
9. How will this affect BlueCard and FEP members?
   BlueCard members with a “PPO in the suitcase” icon on their member card will 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.  
   
   Federal Employee Program (FEP) members will 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 Preferred benefit level.
   
   
10. Will this impact Regence MedAdvantage members?
    No. Regence MedAdvantage members will continue to access the Regence MedAdvantage network of providers.
    
    
11. What should a provider’s office staff be aware of?
    Offices will continue to see member cards displaying:
    
    

    •	One of the following product names: Innova, Engage, Activate or HSA Healthplan 2.0
    •	BlueOption will be displayed above the product name if it is the Preferred network option
    •	Currently, if BlueOption is not displayed, the Preferred network is ValueCare
    •	Office visit copayment amounts and the number of up-front visits will be included, if applicable

    
    
12. What if a member is in her last trimester of a pregnancy when her employer group transfers to the 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 network (Category 1 benefit level), the member will need to choose whether to retain her current physician and deliver at a Category 2 benefit level hospital, or select a provider who does practice at a Preferred network hospital. 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.
    
    
13. What about continuation of care considerations? What if a member is in the hospital at the time of the benefit 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 benefits, 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 benefit level.
    
    
14. Will providers need to sign a BlueOption addendum?
    The current Preferred addendum applies to both Preferred networks so, generally, no additional contracting is needed. Our Network Development team has identified and will be contacting those providers that will need to sign a new addendum.
    
    
15. Why are all ValueCare network providers in the BlueOption network even though they are located next to a hospital that is not in the BlueOption network?
    The Preferred Provider Addendum applies to both Preferred networks; therefore, if a professional provider has signed a Preferred addendum, he or she is part of the ValueCare and BlueOption networks. Hospital agreements are created on an individual (or individual hospital corporation) basis. Therefore, network affiliation can vary.
    
    
16. Where can we find additional information?
    Learn more about BlueOption on our Provider Web Site.
    
    
17. 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. Contact information for your provider consultant is available in the Contact Us section of our Provider Web Site.