East End Health Alliance - FAQ

Background

East End Health Alliance (EEHA) is comprised of Eastern Long Island Hospital, Peconic Bay Medical Center and Southampton Hospital. To date, negotiations with EEHA have been unsuccessful. We are hopeful that EEHA and Empire BlueCross BlueShield, the Empire Plan's hospital insurer will reach an agreement shortly. If not, effective August 1, 2009 EEHA will no longer be a participating provider with Empire BlueCross BlueShield.

How does this affect you?

As of August 1, 2009, only the following services provided by EEHA will be covered on an in-network basis:

• Cases of emergency
• If no network hospital is available within 30 miles of your residence that can provide the services required
• If a network hospital is not available within a 30 mile radius from your home
• For continuation of care for pregnancy if you are in your second or third trimester of pregnancy as of August 1, 2009 you will continue to be covered through the delivery of your child and post-partum care directly related to the delivery
• For any services that were previously preauthorized
• In-patient services for an admission which occurred before August 1, 2009

That means; if you choose to have services at an EEHA facility, except for the special circumstances listed above, you will be covered on an out-of-network basis. It is also important to understand that there will be no immediate interruption of care that is already underway at these hospitals.

What if I am pregnant, can I receive maternity care services at these EEHA facilities?

Yes. If you are in your second or third trimester of pregnancy as of August 1, 2009 you will continue to be covered through the delivery of your child and post-partum care directly related to the delivery.

What if I am not pregnant and I am currently receiving services at EEHA as of August 1, 2009, will my care be interrupted?

No. If you are currently receiving services at an EEHA facility and you are in an ongoing course of treatment, you may continue to receive services at this EEHA facility during a transitional period of up to 90 days.

How will claims for services received at EEHA be paid if they are no longer participating?

Empire BlueCross BlueShield will issue payment for covered services directly to you.

What should you do?

If you are currently receiving services from EEHA or are scheduled for treatment at EEHA and have questions, please call Empire BlueCross BlueShield toll-free at (800) 495-9323, Monday through Friday, between the hours of 7:00 a.m. and 8:00 p.m. The customer service representatives will be able to answer any questions you may have.