01/27/2016

Empire BCBS Expands Partnership with Healthcare Partners

Empire BlueCross and BlueShield (Empire BCBS) has announced an expanded collaboration with Health Care Partners (HCP) to handle certain administrative functions for Empire MediBlue Plus HMO and Empire MediBlue Core HMO members assigned to an HCP primary care provider. This expansion will affect all providers, not just podiatrists.

Please note this expansion does not pertain to services for Empire MediBlue HMO members who are assigned to primary care providers outside of the HCP network. It also excludes Empire MediBlue Dual Advantage DSNP members and Empire MediBlue Access PPO members.

If you have a question on whether or not you are part of the HealthCare Partners network (have a contract with HCP) reach out directly to HealthCare Partners by calling their provider services number 1-844-638-0404.

Effective January 1, 2016, HCP assumed the following administrative functions for Empire MediBlue Plus HMO and Empire MediBlue Core HMO members assigned to an HCP primary care provider:

Medical Management. To obtain authorization or to verify member eligibility, benefits and account information, please call the telephone number listed on the back of the member’s identification card. HCP patients should have the telephone number 1-844-638-0404 on their card.

Prior Authorization Requests. Providers should contact HCP for pre-certifications. Requests can be submitted to HCP electronically through their EZ-Net system, or by fax to 888-746-6433. Empire Medicare Advantage Precertification Requirements can be found here: Medicare Advantage 2016 Precertification Requirements.

Claims Processing
For HCP participating network. HCP participating providers must follow the protocols already established by HCP, which will process the claims in accordance with your HCP contract.

For non HCP participating network. Providers who are not contracted with HCP IPA must continue to submit claims directly to Empire so that we may process the claims in accordance with your Empire contract. 

Credentialing Process
For HCP providers. HCP will handle all credentialing for its participating providers. This includes submission of any demographic changes or terminations.

For non HCP providers. Providers who are not contracted with HCP must continue to follow the Empire processes.

If you have any questions, please contact Empire BCBS Medicare Provider Services Unit at 1-800-499-9554.