Community Health Options has announced a change to their provider network effective yesterday, March 1, 2016. In the past, Health Options supplemented its developing provider netw
ork in New Hampshire with the First Health Network. Their provider relations team has been, and are continuing to actively reach out to First Health Network providers to establish contractual agreements that will create a more direct relationship with Health Options. While many providers are responding favorably, not all wish to establish a direct relationship.
As a result, as of March 1, 2016, First Health Network providers in New Hampshire who have chosen to forgo a contract with Community Health Options will be considered out-of-network.
For this reason, we encourage you to reach out to your doctor’s office to ask if they have established an agreement with Community Health Options directly and if they will be considered an in-network provider going forward. I would also suggest doing a search on the Health Options Provider Network to confirm your doctor(s) are in-network. If they are not, you may want to consider temporarily switching to an in-network doctor to avoid higher out-of-network costs associated with out-of-network providers.
Community Health Options has stated that they may continue benefits at the in-network level for up to 90 days after the provider’s termination date if the provider:
- Continues treatment for an appropriate period of time (based on transition period goals),
- Shares information about the treatment plan with Health Options,
- Continues to follow Health Options’ utilization policies and procedures, and
- Accepts the benefit payments in effect prior to the termination date.
Finally, we are concerned about how little notice Health Options provided to their members about this change. If this network disruption causes problems for you, we would encourage you to call the New Hampshire Insurance Department consumer hotline at 800-852-3416 to express your displeasure at the lack of notice that you were given regarding this change.
We will assist you with finding another plan at the next opportunity, if that is what you desire. Kindly reach out to our office if you are leaning in that direction.