• Commercial Provider Networks
  
• Medicare Provider Networks
  
• Dental Networks
  
• Participating Dental Agreements

Participating (PAR)

The Regence BlueShield Participating Network (traditional network) supports all traditional and indemnity lines of business, and serves as the default for all other networks. As the default, the participating provider agreement is the baseline for all other provider agreements. All providers must sign a participating agreement before joining any other Regence BlueShield provider network.

The PAR Network is offered by Regence BlueShield and used for Regence Life and Health, Regence BlueShield affiliates and subsidiaries and other Blue Cross or Blue Shield Plans (Blue Plans) through The BlueCard^® Program.

Preferred Provider Plan (PPP)

The Regence BlueShield Preferred Plan Provider Network supports our preferred business as well as the Boeing Traditional Medical Plan and the Federal Employees Program.

The PPP Network is offered by Regence BlueShield and used for Regence Life and Health, Regence BlueShield affiliates and subsidiaries and other Blue Cross or Blue Shield Plans (Blue Plans) through The BlueCard^® Program.

Regence RealValue^SM Network

The Regence RealValue network is currently being contracted in these counties:

• King
• Pierce
• Skagit
• Kitsap
• Thurston
• Snohomish

The network supports a new product Regence is preparing for market which will be effective May 1, 2012. Because this product utilizes an “Exclusive Provider Organization” (EPO), members only receive benefits if they go to a Regence RealValue network provider. No benefits are provided to Regence RealValue members if they go out-of-network, except for emergency room care.

Selections Provider Network (POS)

The Selections Provider Network supports the Selections product (including Boeing Selections) as well as individual products. Regence BlueShield Selections members are required to choose a Personal Care Provider (PCP) to receive the highest in-network benefit.

Medicare Provider Networks

Regence MedAdvantage
Our Regence MedAdvantage product uses the Regence BlueShield MedAdvantage network for in-network services with no referral requirements to access specialty care. Regence MedAdvantage provides all Part A and B benefits with additional covered services in one plan.

The Regence MedAdvantage service area includes Clallam, Columbia, Cowlitz, Island, King, Kitsap, Klickitat, Lewis, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Walla Walla, Whatcom and Yakima counties in Washington.

Dental Networks

Contracting and Participating Dental Agreements
Regence contracts with multiple dental professionals, forming dental networks to meet our members' needs. In return we offer predictable reimbursement amounts and schedules, direct payment, and a pool of potential patients.

Participating Dental
The Participating Dental Network serves our members enrolled in our participating fee-for service dental plans in Washington. Participating dentists and dental professionals are reimbursed according to our maximum allowable fee schedule. Payments and a corresponding remittance statement (which explains payment for services provided to our members) are sent directly to participating dental offices each week.

Federal Employee Program Dental
The Federal Employee Program (FEP) Dental Network serves our FEP members enrolled in Washington. Dentists and dental professionals are reimbursed according to our maximum allowable fee schedule. Payments and a corresponding remittance statement (which explains payment for services provided to our members) are sent directly to dental offices each week.

Participating Dental Agreements
Regence has standardized contracting practices and uses a single Dental Group Agreement for multiple providers using a Federal tax identification (ID) number. This agreement will cover all providers doing business under that tax ID number. Providers using their Social Security Number (SSN) will receive an Individual Dental Provider Agreement.

To participate on our dental networks:

• Review the list of provider types to determine if we contract with your specialty and if the network is open to participation.
• Complete a Provider Application:
  • Login to Provider Center
  • Download the Provider Application in the Reference Library
  • If you do not have a Provider Center account, please register
• Sign up for eContracting.

Application Checklist
The following is a checklist of documents that must be legible and included with your Application:

• A photocopy of your current state dental license (with license number, issue date and expiration date).
• A photocopy of your specialty certification(s)/or general anesthesia or conscious sedation permits, if applicable.
• A photocopy of your current malpractice insurance certificate (with policy number, levels of individual aggregate coverage and dates of coverage).
• A photocopy of your current Drug Enforcement Administration certificate(s), if applicable.
• A W-9 indicating how the tax ID is registered with the IRS.