New network changes coming to Business Health Care Group (BHCG)
Effective Jan. 1, 2012, Wheaton Franciscan Healthcare System will be added to the Humana Preferred Network (HPN) and Columbia St. Mary's (CSM) facilities, and the physicians who exclusively admit to
the facilities listed below, will be removed from the HPN. This network change will continue through Dec. 31, 2014.
Humana is pleased to welcome the Wheaton Franciscan Healthcare System to this network. Wheaton facilities include: All Saints; Elmbrook Memorial; Wheaton Franklin; St. Francis; St. Joseph; The Wisconsin Heart Hospital; and the Midwest Orthopedic Specialty Hospital. In addition, hospital systems that will continue to be a part of HPN include: Aurora Health Care®; Beloit Health System; Children's Hospital of Wisconsin®; Fort HealthCare; Froedtert Health; Mercy Health System; ProHealth Care; St. Nicholas Hospital; United Hospital System; and Watertown Regional Medical Center.
CSM facilities, including CSM Milwaukee, Sacred Heart Rehabilitation Institute, CSM Women's Hospital, CSM Ozaukee, and The Orthopedic Hospital will be considered out-of-network for Humana HPN members. The termination of CSM only impacts HPN members within the BHCG HPN. It will not impact Medicare Advantage, Group Medicare, or non-HPN members within the BHCG on a PPO, HMO or NPOS plan.
Humana understands this represents a change for some of your clients and for health plan members. To begin the communication process, please note the following:
- Humana will administer the required notification and continuity of care process, according to state regulatory requirement, for the applicable fully insured members.
- In addition, Humana is working with the BHCG ASO employers to determine the preferred method of communicating continuity-of-care information to impacted plan members, if any.
As the cost of healthcare continues to rise, Humana is committed to keeping healthcare as affordable as possible for health plan members and employers, while also offering an extensive, quality HPN in Southeastern Wisconsin. The new HPN network continues the commitment of providing comprehensive geographic coverage for Southeast Wisconsin.
If you have any questions, please contact your Humana Account Executive or Sales Executive.
