National Account Groups Will Soon Have Access to the Blue Value Network
Beginning January 1, 2018, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will offer national account groups whose employees’ coverage is administered by other Blue Cross and/or Blue Shield plans access to our Blue ValueSM provider network.
National accounts are employer groups that:
- Have offices or branches in more than one state AND
- Offer uniform benefit coverage to all employees, regardless of the state in which the employees work or reside, or the number of employees in different locations
The Blue Value network is:
- A point-of-service (POS),limited network of providers in locations across North Carolina
- An Affordable Care Act-compliant product with lower monthly premiums
The Blue Value network will be available to national account employer groups who choose limited network products that align with our Blue Value network. Offered by other Blue Cross and/or Blue Shield plans, these limited-network products will be branded with the Blue Value name, and available for national account group employees in North Carolina. These members’ identification cards will display the Blue Value name, making it easy for providers to recognize members from other Blue Cross and/or Blue Shield plans.
Offering these members access to the Blue Value provider network allows them to receive health care from providers participating in a network that supports the same limited network product type in which they (the members) will also be enrolled. Members enrolled in Blue Value products are eligible to receive the highest level of benefits when they access care from providers also participating in the Blue Value network. Providers participating in the Blue Value network will receive eligible payments based upon their Blue Cross NC Blue Value reimbursement allowances for services provided to both national account Blue Value members and Blue Cross NC’s Blue Value members.
At this time, we anticipate approximately 300-500 national account members will become eligible to access Blue Cross NC’s Blue Value network, beginning January 1, 2018. These new members will be enrolled in a Blue Value product to be offered by Highmark Blue Cross Blue Shield, and the majority of these new members already reside and work in the Triangle area. Additional details about this new membership, as well as potential future membership expansion, is available in the FAQs below.
National account Blue Value members with benefits from other Blue Cross and/or Blue Shield plans will also be BlueCardSM eligible. This design allows providers participating in the Blue Value network to manage claims, verify members’ benefits and eligibility, and request authorizations for services using familiar processes through the BlueCard program.
Blue Value members must obtain their health care services from providers participating in the Blue Value, POS network to be eligible to receive their highest level of in-network benefits. Services obtained from Blue Cross NC-participating providers who are not also participating in the Blue Value network, will typically result in the member receiving a reduced benefit for any eligible service provided them, as well as greater out-of-pocket responsibilities.
National account Blue Value members will use the Blue Cross and Blue Shield Association’s National Doctor and Hospital Finder tool to locate in-network providers they can see as part of their Blue Value benefit designs. Members will enter their Blue Plan-assigned alpha prefixes, along with the North Carolina locations in which they are looking for providers, and the specialty types for the providers they’re searching. This will result in a listing of Blue Value network providers within the National Doctor and Hospital Finder tool, which matches the input criteria for the searched in-network providers.
Additional information about National Accounts accessing the Blue Value network is available in these FAQs.