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Recent negotiations between Nemours duPont Pediatrics of Pennsylvania and Highmark of Pennsylvania have thus far failed to produce a fair and equitable contract. As a result, Nemours duPont Pediatrics in Pennsylvania will no longer be considered a participating provider with Highmark of Pennsylvania beginning August 1, 2016.
This change does not apply to families with coverage through Highmark Blue Cross Blue Shield of Delaware. Further, Highmark of Pennsylvania patients will still be able to receive care at Alfred I. duPont Hospital for Children and from Delaware-based Nemours duPont Pediatrics providers at the in-network rate through the BlueCard* program.
Families with coverage through Highmark of Pennsylvania wishing to continue receiving care from a Pennsylvania-based Nemours duPont Pediatrics provider may consider transferring their child’s care to one of our Delaware-based providers. For those families wishing to choose another non-Nemours physician for their healthcare care needs, we will do our best to make the transition as smooth as possible.
Children receiving care as part of an existing care plan with a Pennsylvania-based Nemours duPont Pediatrics provider at the time of the termination date may continue to receive that care for up to 60 days following the termination date. Contact Highmark of Pennsylvania for details.
Families wishing to continue a relationship with a Pennsylvania-based Nemours duPont Pediatrics provider should speak with their benefit administrator as soon as possible to determine other insurance carrier options which identify Nemours duPont Pediatrics as an in-network and participating provider. If you do not have the ability to switch to a different insurance carrier, we suggest you call Highmark of Pennsylvania for a listing of in-network physicians.
*BlueCard is a national program that enables members of one Blue Cross and Blue Shield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan’s service area. BlueCard links participating health care providers with the independent BCBS Plans across the country, and in more than 200 countries and territories worldwide, through a single electronic network for claims processing and reimbursement. For more information about the BlueCard Program, call your Highmark Blue Shield Provider Relations Representative or visit the Blue Cross and Blue Shield Association’s Web Site at www.bcbs.com.