The Blue High Performance
NetworkSM (BlueHPNSM) is a type of narrow network available in more than 68 major U.S. markets, including the Independence Blue Cross (Independence) five-county service area. BlueHPN is designed to support providers in their ongoing quest to improve health outcomes while keeping costs in check.
While BlueHPN is typically narrower than the PPO network, it includes a full breadth of provider types – from primary care to specialists and hospitals. Launched in January 2021, BlueHPN is offered only with EPO plans; as such, out-of-network coverage is limited to urgent/emergent care only. BlueHPN patients are also limited to urgent/emergent care at non-BlueHPN providers in non-BlueHPN markets.
Plan design example
Blue Cross of Idaho offers BlueHPN to the employees of Albertsons Companies who reside in the Independence service area.
Albertsons' BlueHPN EPO® benefit design will be supported by Independence's BlueHPN/Personal Choice Limited network. Out-of-network coverage is limited to urgent/emergent care only. In addition:
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PCP visits are covered at a $20 copay.
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Specialist office visits are covered at a $40 copay.
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Deductible is $1,500 for an individual and $4,500 for a family.
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Coinsurance plan pays 70%; member pays 30%.
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For inpatient hospital care, the deductible and coinsurance apply.
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Emergency care is covered at a $200 copay.
Providers can recognize members with BlueHPN by the Blue High Performance name and the HPN in a suitcase logo on the member ID card. As a reminder, all members are subject to eligibility verification and the applicable precertification requirements of their Home Plan.
Here is a sample of the ID card:
The claims filing requirements are different for BlueHPN compared to BlueCard® PPO/Personal Choice PPO. All professional and facility provider claims for BlueHPN members must be submitted to Independence.
Providers may use the
PEAR portal to determine if their facility or professional practice is part of the BlueHPN/Personal Choice Limited network.