Network development for professional providers and hospitals

Participation in the professional provider network is open to providers who meet our participation requirements and who accept our fee structure. Our Silver plan includes primary care and specialty practitioners (such as cardiology, general surgery, neurology, obstetrics and gynecology, orthopedics, and urology) who meet our credentialing requirements to ensure members have access within a reasonable distance to the number and types of clinicians needed.

In developing the hospital network, including networks available to exchange Gold, Silver, and Bronze tier plans, we do not use criteria related to quality, patient safety, experience, cost measures, or geography. Participation in the hospital network is open to hospitals who meet our participation requirements and who accept our fee structure.

In developing our hospital network, we make sure that members have access to hospitals within a reasonable driving distance.