Here are answers to some questions about Blue HPN

We’ve received some questions about our Blue High Performance Network℠, also called Blue HPN℠, which we wrote about in a November 2020 Record article. As you may have read, members who have Blue HPN in Southeast Michigan only pay the plan’s out‑of‑pocket expenses if they receive services from a Blue HPN health care provider.

Here are answers to some questions we recently received:

Q: Can a specialist treat a member with Blue HPN?

A: Yes. While referring a patient with Blue HPN to an Ascension provider is recommended, there are some specialty types and ancillary providers who aren’t affiliated with Ascension who patients can still see without being responsible for the full cost of treatment. These include chiropractors, skilled nursing home providers, behavioral health specialists, home health care providers and limited medical specialists who are in Blue Cross Blue Shield of Michigan’s PPO network. We want to be sure that providers in those specialty areas know they can treat Blue HPN members. Here’s a complete list of specialties that can treat Blue HPN members if they are within our PPO.

Referring providers should advise their patients to check our online directory, Find a Doctor, to ensure that a provider is in the Blue HPN or call the number on the back of their member ID card.

Q: What about facility services?

A: While specialists may be included in Blue HPN — and their claims processed as Professional in-network claims — related facility claims may be processed as out of network if a patient with Blue HPN goes to a non‑network facility. If you’re affiliated with a non-Ascension hospital, you’ll want to encourage your patient to get any necessary facility services at a Blue HPN facility. As a reminder, emergency services are covered benefits at Blue HPN facilities and non‑Blue HPN facilities within the broader PPO network.

Q: How will I know if a member has Blue HPN?

A: You can check the bottom left-hand corner of their member ID card. It features a suitcase logo with the initials “HPN” inside. Also, you can determine if a member has Blue HPN in web‑DENIS when checking eligibility.

Q: How do I know if a specialist or ancillary provider participates with Blue HPN?
If they participate with Blue HPN, their listing in the network directory will indicate that. You can check out the Find a Doctor search feature to see what plans a specific provider accepts.

For more information, see the November 2020 Record article or watch this video.