As of this update, we have no plans to drop any of the insurers with which we now participate. However, we are always reassessing our insurance contracts. If you have questions about your particular plan, or our future prospects with them, please feel free to discuss this with us.
We terminated our contract with Horizon Blue Cross of NJ as of 5/15/2002. For the details of why, click here.
6/1/2007 -- After two and a half years of negotiations with Horizon Blue Cross of New Jersey, their last, best offer was not acceptable, primarily because of very low fees for the "managed" products (HMO, POS, NJ Plus, etc.). And, with the state putting all of the Horizon members of the State Health Benefit Plan (SHBP) into a thinly veiled HMO*, it is even more difficult to consider Horizon participation. We are sorry for the uncertainty and long delay surrounding these negotiations. We are still talking with them and have some (small) hope that they will improve the fees in order to entice more of the area's physicians to join. Check back here for any new information.
* Yes, the SHBP Horizon option is not really a PPO as you were told. This is because you only have access to the 'managed' (i.e. HMO) network as 'in-network' docs, which is a much smaller network than the PPO network because of the lower fees. Even when we were participating with Blue Cross, we never took their HMO products (which include POS, Direct Access and the new Direct 10 and Direct 15).
Contracts have been signed with each of these plans. The effective dates are as follows:
| Plan | - | Effective |
|---|---|---|
| Qualcare | - | 12/1/2006 |
| MultiPlan | - | 2/1/2007 * |
| HealthNet | - | 3/1/2007 ** |
We are talking with or have talked with a number of other plans, but nothing promising is on the horizon. Check back for updates.
If you are in a plan which you would like us to consider, either have the plan contact us, or send us the contact information and we will contact them. Please understand, however, that there are a large number of (mostly small) insurance plans out there which pay very poorly (below Medicare) or have very poor specialist networks. In addition, many of them have track records of paying less than they promise, giving all kinds of excuses. We can not participate with them. In order to continue to deliver the high quality care which we believe you deserve, we must be paid fairly and we must have access to the specialists we need, and we mus be paid according to the contract and state laws on timely payments.