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Nov
08
2016

Important information for Fairview patients with Blue Cross insurance coverage

Posted 344 days ago ago by Fairview Range

Fairview Blue Cross Information Hotline
If you have questions about the letter(s) you’ve received regarding contract negotiations between Fairview and Blue Cross, please call the Fairview Blue Cross Blue Shield Information Hotline at 612-336-2626.

The hotline is staffed Monday-Friday, 8 a.m-6:30 p.m. You may also leave an after-hours voicemail on the hotline, and we will return your call the following business day.


As your health care provider, we are concerned first and foremost about providing you with the best possible care and service. In that spirit, we want to make you aware of a possible change that may affect your care moving forward.


For the past several months, Fairview and Blue Cross Blue Shield of Minnesota have been working to reach a new contract agreement for Fairview’s participation in Blue Cross insurance products. Despite strong efforts, we have not yet reached an agreement. 

What this means for Fairview patients
We want to be sure you are aware of this circumstance, particularly during the fall, when you may be selecting health insurance coverage for 2017. 

As you consider your open enrollment options, we want you to know what happens if Fairview does not have a contract with Blue Cross by year end. Without a contract, Fairview would no longer be considered a member of Blue Cross’ network. That means Fairview would be an out-of-network provider effective Jan. 1, 2017.

You can still choose to use Fairview providers and services. However, effective Jan. 1, 2017, Blue Cross may cover those services at your insurance plan’s out-of-network benefit level. This typically means you will pay more out-of-pocket costs.

Please know that we value you and your family as Fairview patients, and we will continue to offer services to all patients who choose us for their care. However, we feel it’s important to let you know that your costs for Fairview services may change if Fairview is not in Blue Cross’ network in 2017.

Below is further information to help you understand what this may mean for your medical care. 

If you have additional questions about your insurance coverage, please contact your employer’s benefits department or call the Blue Cross customer service phone number found on the back of your member ID card. 

Questions & Answers
Health Care Services for Blue Cross Members Provided By Fairview
Nov.-Dec. 2016

Q: I understand Fairview could soon be out-of-network with Blue Cross. What does that mean?
A: Out-of-network providers are those who do not have agreements with a particular insurance plan. Patients typically pay more out-of-pocket costs when they use out-of-network providers.

Q: If an agreement isn’t reached and Fairview is out-of-network for Blue Cross insurance coverage in 2017, are there any exceptions?
A: In certain circumstances, you may qualify for continued care with Fairview for a period of time after December 31, 2016, and claims may be paid with Fairview as an in-network provider. Please call the number on the back of your insurance card to get complete details about the specific qualifying circumstances.

Q: What are my options if I want to ensure I have Fairview in-network coverage on Jan. 1, 2017?
A: There are a number of options:
  • You can review all of your medical plan options, determine whether Fairview is an in-network provider and enroll in one of those plans for 2017 (if you have an open enrollment period this fall).
  • If you have employer-sponsored medical plan options, you can talk with your employer about your concerns about Fairview potentially being out-of-network with Blue Cross and encourage them to offer options that include Fairview.
  • You can contact Blue Cross member services to express your concern about Fairview potentially being out-of-network.
  • You can contact Blue Cross member services to ask for a list of Fairview Physician Associates providers who will be in network in 2017. (These are independent providers affiliated with Fairview.)

Q: Should I be looking for a new doctor?
A: At Fairview, we believe continuity of care leads to better health outcomes for you and your family. That is why our focus is on ensuring that you can continue to have access to your Fairview provider of choice at in-network benefit levels.

We are hopeful we will reach an agreement with Blue Cross, so that Fairview services will continue to be covered at the in-network benefit level after Dec. 31. If we do not reach an agreement, you still have the flexibility to retain your Fairview provider. However, Blue Cross will cover those services at the out-of-network benefit level. Call the number on the back of your insurance card if you would like more details about your medical plan coverage.

If you are a patient at an independent Fairview Physician Associates clinic, you can call the number on the back of your insurance card if you would like more details about whether your provider will be in network in 2017.

Q: Which Fairview services could be out of network Jan. 1, 2017?
A: If an agreement is not reached by Dec. 31, 2106 the following Fairview care and services will be out-of-network effective Jan. 1, 2017:
Fairview hospitals, clinics, surgery centers and Express Cares
Fairview Behavioral Health Services
Fairview Counseling Centers
Fairview Hand Centers
Fairview Home Medical Equipment
Fairview Home Care and Hospice
Fairview Orthotics and Prosthetics
Fairview Pain Management Center
Fairview Partners
Fairview Recovery Services
Fairview Rehabilitation Services
Fairview Sleep Centers
Fairview Sports and Orthopedic Care
Institute for Athletic Medicine
Hematology Oncology and Cardiology services provided in the University of Minnesota Health Clinics and Surgery Center

Call the number on the back of your insurance card if you would like more details about your medical plan coverage.

Q: I have a Fairview visit scheduled before Jan. 1, 2017. Can I keep that appointment?
A: Yes. Fairview services will be covered at the in-network level of your insurance plan until Jan. 1, 2017.

Q: Should I cancel Fairview visits scheduled on/after Jan. 1, 2017?
A: We are hopeful we will reach an agreement with Blue Cross and that Fairview services will continue to be covered at the in-network benefit level. If we do not reach an agreement, you still have the flexibility to retain your Fairview provider. However, Blue Cross will cover those services at the out-of-network benefit level. Call the number on the back of your insurance card if you would like more details about your medical plan coverage.

Q: Can I continue to see my University of Minnesota Physicians (UMP) provider?
A: UMP providers are not affected by Fairview’s contract with Blue Cross. Please call the UMPhysicians Business Office at 763-782-6500 for more information.

However, if you receive care from a UMP provider at a Fairview facility, such as University of Minnesota Medical Center, the care and services provided by Fairview staff may be out-of-network effective Jan. 1, 2017. Please call the UMPhysicians Business Office at 763-782-6500 for more information.

Q: Can I continue to see my Fairview Physician Associates (FPA) provider?

A: Fairview Physician Associates (FPA) clinics have their own contracts with insurance companies. Please call the number on the back of your insurance card if you would like more details about your medical plan and to see if your provider is considered in or out of network for your particular plan.

Q: I have a medical procedure planned at a Fairview hospital. What should I do?
A: Blue Cross will continue to cover Fairview hospital services at the in-network benefit level of your medical insurance plan until Jan. 1, 2017. This includes services at: Fairview Lakes Medical Center, Fairview Northland Medical Center, Fairview Ridges Hospital, Fairview Southdale Hospital, University of Minnesota Medical Center, University of Minnesota Masonic Children’s Hospital, Fairview Range Medical Center, Maple Grove Surgery Center, Crosstown Surgery Center, Ridges Surgery Center and Northwoods Surgery Center.

If Fairview and Blue Cross do not reach an agreement, you still have the flexibility to receive services at these Fairview facilities. However, Blue Cross will cover those services at the out-of-network benefit level. We are hopeful we will reach an agreement with Blue Cross so Fairview services will continue to be covered at the in-network benefit level effective Jan. 1, 2017.

Q: Will Fairview Pharmacy services be affected?
A: No. Fairview Pharmacy services are not included in this contract negotiation and are not affected.

Q: What other insurance plans offer Fairview in-network coverage?
Fairview has contracts with the following:
HealthPartners (agreement also covers Cigna members) - 1-800-244-6224
PreferredOne (agreement also covers Aetna members) - 763-847-4000
Medica - 952-945-8000
UCare - 1-866-457-7144
America’s PPO – HealthEz - 952-896-1201 or 1-800-948-9451
Multiplan - 800-922-4362First Health/Coventry -1-800-226-5116

Q: Is United Healthcare in network for Fairview?
A: Please check with United Healthcare, as there are a variety of plans which may or may not be in network for Fairview. The number to call is 1-866-633-2446.

Q: I have Medicare coverage along with Blue Cross supplemental insurance. Will my Blue Cross supplemental plan include Fairview as an in-network provider in 2017?
A: Please call the number on the back of your insurance card for more details about your Blue Cross supplemental plan coverage.

Q: Do these negotiations affect patients who use other insurance carriers?
A: No. These negotiations affect patients who use Blue Cross insurance and do not affect patients using other insurance carriers.


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