Anthem Blue Cross's Medical Provider Network (MPN)

Anthem Blue Cross is committed to providing the most comprehensive Medical Provider Network (MPN) in the industry treating injured workers throughout the State of California.

Background: In 2004, the California legislature approved Senate Bill 899 which allows for the establishment of Medical Provider Networks (MPNs) to treat work-related injuries.

What is an MPN?: An MPN is a network or group of health care providers established by insurance carriers or self-insured employers that have been approved by the Division of Workers' Compensation to provide care for injured workers. MPNs are required to meet access to care requirements in order to be approved. Additional criteria for approval includes; economic profiling policy, continuity of care and transfer of care policies, as well as a second and third opinion process if the injured worker disputes the diagnosis or treatment plan of the treating MPN providers.

What are the advantages of an MPN? Prior to the establishment of MPNs, the employers and insurance carriers had 30 days of medical control. With an MPN, they now have medical control for the life of the claim. Additionally, MPNs are expected to generate cost savings by keeping the treatment within the network.

Size and Scope of the Anthem Blue Cross Life & Health Network: Anthem Blue Cross Life & Health's network provides statewide access to a proven workers' compensation PPO with impressive discounts. The Anthem Blue Cross network includes nearly 400 Frontline/industrial medical clinics, 400 hospitals, 300 ambulatory surgical centers, and 45,000 physicians. Other ancillary providers in the network include; DM E vendors, home health care, physical therapists, chiropractors, occupational therapists, and diagnostic facilities.

The DWC has approved the Anthem Blue Cross PPO as meeting access to medical care standards statewide.

Anthem Blue Cross Life & Health's MPN includes the following:

	Access to the largest state certified PPO network in California
	Application template that includes the necessary continuity of care and transfer of care policies, second and third opinion process, and the independent medical review (IMR) process
	Provide the necessary notification/education materials for employees (English and Spanish)
	Web-based Provider Finder
	Dedicated 800 number for assistance locating a provider or making appointments (866-700-2168)
	Web-based provider nomination process (bccnominations@wellpoint.com)

Additional Services:

	URAC approved utilization review and total case management programs
	Physician Peer Review
	Bill re-pricing

For more information regarding the Anthem Blue Cross Life & Health MPN please call 866-700-2168 or use the contact us link on our website.

*Anthem Blue Cross Life and Health Insurance Company and Anthem Blue Cross are independent licensees of the Blue Cross Association.