Q: Which HNE members will be able to use the SPHS services?
A: SPHS will be joining HNE’s network for self-insured employer groups administered by HNE. This includes about 18,000 of the more than 90,000 members covered by HNE. All HNE members currently have access by referral to some SPHS services, including services at the Weldon Rehabilitation Hospital and the behavioral health services offered at Providence Behavioral Health Hospital in Holyoke.
Q: Are all physicians with privileges at Mercy Medical Center included in this agreement?
A: Many physicians with staff privileges at Mercy Medical Center are already part of the HNE provider network. In connection with this new agreement, HNE has also reached agreements with hospitalbased physicians at Mercy Medical Center. HNE will continue to consider other additions to our physician provider network as our relationship with SPHS continues.
Q: When is the agreement effective?
A: The contractual agreement is effective as of Jan. 1, 2003. HNE will be notifying affected members by mail and will be sending out new, specially designed membership cards to identify members with access to SPHS facilities.
Q: Are all SPHS services offered?
A: The agreement covers a broad range of services, including services at Mercy Medical Center, the Weldon Rehabilitation Hospital and Providence Behavioral Health Hospital. Existing benefit limits and exclusions of each applicable coverage plan will apply to services at these facilities. Agreements for some SPHS services such as the SPHS home care agency, are still being negotiated.
Q: Will SPHS be included in HNE’s network for its other members? When?
A: HNE and SPHS will continue to discuss a broader role for SPHS in HNE’s provider networks. Over the next several months, HNE and SPHS will gain information about how the new relationship is working, and will then begin discussions about including SPHS in the provider networks that HNE offers to its other members.