The current contracts between Independence Blue Cross and Tenet Health System for Hahnemann University Hospital and St. Christopher’s Hospital for Children are scheduled to end on May 1, 2008. IBC remains optimistic that all parties will agree on new contract terms prior to the expiration date. IBC efforts will continue non-stop to resolve all contract issues on their members’ behalf before the deadline.

However, employees need to be prepared for the possibility that the contracts will end as scheduled. If the contract with Tenet ends, any services that members obtain from Tenet will be considered out-of-network services.

WHAT IS THE IMPACT TO MEMBERS IF THE CONTACT EXPIRES?
If the Tenet contract expires on May 1, 2008, Tenet Health System and its affiliated physician practice groups will no longer be part of IBC’s network that serves the following health plans: 

• Personal Choice
• Personal Choice 65
• Traditional
• CompSelect and Comprehensive Major Medical
• Keystone Health Plan East HMO
• Keystone 65
• Keystone 65 Choice
• Keystone Point-of-Service
• Keystone Direct POS
• Keystone 65 Direct Point-of-Service

WHAT DOES THIS MEAN TO YOU AS AN EMPLOYEE?
Because the Tenet Health System contract may expire May 1, 2008, beginning April 1, 2008, IBC will neither preauthorize nor reimburse for medical services scheduled on or after May 1, 2008, at Tenet hospitals for members in the following plans: HMO, POS (referred care), Direct POS (in-network benefits), or PPO (in-network benefits). However, IBC will cover services or hospital admissions scheduled to take place on or after May 1, 2008, but only if they have been preauthorized prior to April 1, 2008.

A physician may request an exception to the above, pursuant to IBC policy, the member’s benefit plan, and applicable state regulations, for members who are in active treatment with Tenet and are receiving treatment that is medically required to continue after May 1, 2008. All physicians who wish to request an exception must call the Care Management and Coordination department at 1-800-ASK-BLUE.

WHAT SHOULD I DO NEXT?
If your primary care physician (PCP) is part of a Tenet practice that ends its network participation, you will need to select a new PCP to be effective May 1, 2008. You can search for a new PCP by using the provider directory at www.ibx.com.

To select a new PCP, employees can login to www.ibxpress.com and select the “Change your Primary Care Physician” link under the Self Service section of the website. You can also contact Customer Service at the telephone number listed on their identification card to select a new PCP.

In the event of the contract termination between Tenet Health System and IBC on May 1, 2008, Please contact your HR department or your dedicated BenefitsVIP team for assistance.

IT IS IMPORTANT TO REMEMBER that effective May 1st, Hahnemann University Hospital and St. Christopher’s Hospital for Children will be considered out-of-network hospitals. We have included several documents which contain the current in-network hospitals. While these documents are comprehensive, please keep in mind that changes and updates may occur.

Click here to obtain a list of Keystone Direct POS in-network hospitals.

Click here to obtain a list of Keystone HMO-POS in-network hospitals.

Click here to obtain a list of Personal Choice PPO in-network hospitals.

Click here to get an update on the status of the contract.