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January 2015

Update: Metro Detroit EPO, HMO networks

Reminder
Here are three important points to keep in mind:

  • Other than eligible emergency services and accidental injuries, members who have enrolled in a Metro Detroit EPO plan do not have coverage if they visit a doctor that is outside the network.
  • Be sure to always refer members to health care providers that are in the Metro Detroit EPO network. You can use the Find a Doctor search tool on bcbsm.com to verify that a doctor or hospital is in this network.
  • Be sure your office staff knows if you are in this localized network.

We’ve recently learned the St. Joseph Mercy — Port Huron will not be a participating hospital in the Blue Cross® Metro Detroit EPO and HMO networks. To reflect this change, we’ve updated the November Record and the November-December issue of BCN Provider News.

For your reference, below is a current list of participating hospitals and product names. We also want to let you know that our online tutorial on the Metro Detroit EPO and HMO networks is now available on web-DENIS. The tutorial will walk you through our new individual plans with these local networks.

To view the presentation, you can click on the link above. Or, when you log in to web-DENIS, follow these steps:

  • Log in to Provider Secured Services.
  • Click on web-DENIS.
  • Click on BCBSM Provider Publications and Resources.
  • Click on Newsletters & Resources.
  • Go to the What’s New section and click on Training presentation: Blue Cross Metro Detroit EPO and HMO local networks.

You can also find it on these pages:

  • In the navigation menu, go to Operations and Training and click on Products and networks. Then, click on Training presentation: Blue Cross Metro Detroit EPO and HMO local networks.
  • In the navigation menu, go to Health Reform and click on Information. Scroll to Product information and click on Training presentation: Blue Cross Metro Detroit EPO and HMO local networks.

Blue Cross Metro Detroit EPO and HMO — Participating hospitals

  • Detroit Medical Center
    • DMC – Children’s Hospital
    • DMC – Detroit Receiving
    • DMC – Harper — Hutzel
    • DMC – Huron Valley — Sinai
    • DMC – Sinai Grace
    • DMC – Rehabilitation Institute of Michigan
  • Oakwood Healthcare, now part of Beaumont Health*
    • Oakwood Hospital and Medical Center, Dearborn
    • Oakwood Hospital Southshore
    • Oakwood Hospital Taylor
    • Oakwood Hospital Wayne
  • St. John Providence Health System
    • Providence Hospital
    • Providence Park Hospital
    • St. John Hospital and Medical Center
    • St. John Macomb — Oakland Hospital Macomb Center
    • St. John Macomb — Oakland Hospital Oakland Center
    • St. John River District Hospital
  • Saint Joseph Mercy Health System/CHE Trinity Health
    • St. Joseph Mercy — Ann Arbor
    • St. Joseph Mercy — Chelsea
    • St. Joseph Mercy — Livingston
    • St. Joseph Mercy — Oakland
    • St. Mary Mercy Hospital — Livonia
  • Botsford Hospital, now part of Beaumont Health*
  • Garden City Hospital
  • Stonecrest Center for Behavioral Health
  • Straith Hospital for Special Surgery

    *Note: Beaumont Health campuses in Royal Oak, Troy and Grosse Pointe are not part of the EPO network.

Blue Cross Metro Detroit EPO and HMO — Product names

  • Blue Cross® Metro Detroit EPO Gold Extra
  • Blue Cross® Metro Detroit EPO Silver Extra
  • Blue Cross® Metro Detroit EPO Silver
  • Blue Cross® Metro Detroit EPO Bronze Extra
  • Blue Cross® Metro Detroit EPO Bronze
No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.