Important information for Fairview patients in the Blue Cross Aware network

For the past several months, Fairview and Blue Cross Blue Shield of Minnesota have been working to reach a new agreement for Fairview's participation in the Blue Cross Aware network. We remain hopeful we will reach an agreement with Blue Cross before the contract expires Aug. 23, so your Fairview providers and services can continue to be covered at in-network benefit levels.

As your health care provider, we are concerned first and foremost about your medical care and are committed to reaching an agreement that does not compromise the exceptional, high-quality care and service that you know and trust. To keep you informed, we have created this special Web site. Check it often to understand what this situation means for you and your medical care. You also can call us at 612-672-7272. (If you have questions about your Blue Cross coverage, contact Blue Cross online or call the customer service number on the back of your medical card.)

Each of Fairview's more than 22,000 employees and providers is deeply committed to providing an exceptional patient and family experience. We appreciate the opportunity to serve as your health care provider and look forward to doing so in the future.

Answers to your questions

Q1: I heard Fairview could soon be out-of-network with Blue Cross. What does that mean?
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.

Q2: I want to continue using Fairview services as I do today. Who should I talk to?
You may contact: Blue Cross Blue Shield customer service (or, call the number on the back of your Blue Cross member ID card) and your benefits department at work. Let them know you value the care you receive at Fairview and it is important that medical care at Fairview remain accessible to you.

Q3: Should I be looking for a new doctor?
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 and that Fairview services will continue to be covered at the in-network benefit level after Aug. 23. 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.

Q4: Which Fairview services could be out of network Aug. 23?
As your provider, our top concern is your care. We are hopeful that we will reach an agreement with Blue Cross before the contract expires, so you can continue to choose Fairview providers and have those services covered at the in-network benefits level. If an agreement is not reached by Aug. 23, the following Fairview clinics and other outpatient services will be out of network:

• Fairview clinics in the greater Minneapolis/St. Paul metro area
• Fairview Counseling Centers
• Fairview Hand Centers
• Fairview Home Medical Equipment
• Fairview Orthotics and Prosthetics
• Fairview Pain and Palliative Care Clinic
• Fairview Sports and Orthopedic Care
• Institute for Athletic Medicine

A complete list of Fairview locations affected by this potential change also is available.

Q5: I have a clinic/therapy visit scheduled before Aug. 23. Can I keep that appointment?
Yes. Fairview services will be covered at the in-network level of your insurance plan prior to that date.

Q6: Should I cancel clinic/therapy visits scheduled on/after Aug. 23?
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 after Aug. 23. 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.

Q7: I am pregnant and receive medical care at Fairview and/or plan to deliver at Fairview hospital. Should I be looking for a new provider?
To understand your insurance coverage options, contact Blue Cross customer service. Blue Cross has indicated that members in their second and third trimester of pregnancy typically would not make a transition but would be able to continue their current care through delivery and still receive in-network benefits. Please call the customer service number on the back of your insurance card for further assistance.

Q8: Would Fairview Pharmacy or Fairview Home Infusion be affected by this change?
No, these contract negotiations do not affect how you receive services from Fairview retail pharmacies, Fairview Specialty Pharmacy or Fairview Home Infusion.

Q9: I am currently receiving chemotherapy/outpatient rehab services (physical, occupational, speech therapy) at a Fairview hospital. How will those treatments be covered on/after Aug. 23?
Any services billed through a Fairview hospital will remain in-network until Oct. 28. If you are not sure if the service you are receiving is billed through a Fairview hospital, contact Blue Cross customer service for more information.

Q10: Would University of Minnesota Physician clinics also be out of network Aug. 23?
No. This potential change to the Blue Cross Aware network would only affect these Fairview facilities.

Q11: I have a medical procedure planned at a Fairview hospital. What should I do?
Blue Cross will continue to cover Fairview hospital services at the in-network benefit level of your medical insurance plan until Oct. 28. This includes services at: Fairview Lakes Medical Center, Fairview Maple Grove Surgery Center, Fairview Northland Medical Center, Fairview Ridges Hospital, Fairview Southdale Hospital, Fairview University Medical Center – Mesabi, and University of Minnesota Medical Center, Fairview. (See Q13 for information on Red Wing.)

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 Oct. 28.

Q12: I use Fairview services in the Hibbing area. How could this affect me?
Fairview Mesaba Clinics in Hibbing, Chisholm, Nashwauk and Mountain Iron have a separate Blue Cross contract, and they are not directly affected at this time. You can continue to receive care at those clinics at the same benefit level. The Fairview hospital in Hibbing, Fairview University Medical Center – Mesabi, may be affected by this negotiation. If an agreement is not reached, hospital services would be covered by Blue Cross at out-of-network levels effective Oct. 28.

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 after Oct. 28. 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.

Q13: I am a Fairview Red Wing patient. How could this affect me?
Fairview clinics in Red Wing and surrounding communities have a separate Blue Cross contract, and they are not directly affected at this time. You can continue to receive care at those clinics at the same benefit level. The Fairview hospital in Red Wing—Fairview Red Wing Medical Center—may be affected by this negotiation. If an agreement is not reached, hospital services would be covered by Blue Cross at out-of-network levels effective Nov. 7.

Q14: Why haven’t Fairview and Blue Cross reached an agreement?
Fairview is expecting a reimbursement rate increase from Blue Cross that will enable us to continue our mission of serving our communities and is reflective of the remarkable value we provide. Fairview is known for delivering high-quality clinical outcomes through collaborative relationships with patients, families and providers. As a result, we are the most comprehensive provider in the greater metro area—offering clinical care and services not available elsewhere. With partners such as Medica, we are redesigning care delivery models to be more effective and efficient for patients, families, providers and employers. We need to expand that work. We are still hopeful that Blue Cross will offer us a contract that meets these needs.

The rates Fairview is expecting from Blue Cross are similar to those we have established with all other major insurers in our marketplace, including HealthPartners, Medica and PreferredOne.

Q15: Which Blue Cross networks/products are affected?
The out-of-network status primarily affects the Blue Cross Aware PPO network/product. This does not affect primary care designated services for Blue Plus. If you’re not sure if your Blue Cross plan is affected, look at your insurance card to see the name of your network and call the customer service number on the back of your insurance card.

Q16: Do these negotiations affect patients who use other insurance carriers?
No. These negotiations primarily affect patients who use the Blue Cross Aware network. Fairview has agreements in place with other Blue Cross products/networks, as well as all other major insurance providers in Minnesota, including HealthPartners, Medica and PreferredOne.

Q17: How can I stay informed about this situation and what it means for my health care?
We have created this special Web site to provide you information and updates. You also can call Fairview at 612-672-7272.