Corewell Health East employees

Corewell Health East (Beaumont Health) employees moved to Priority Health as their health plan in 2023

As you care for these patients, we've outlined a few things to know.

A provider is eligible to participate in the Beaumont Health Network Plan (BHNP) if:

• Provider was part of the former Third-Party Administrator, UMR (as substantiated by provider via email, prism inquiry or by BACO via PRA)

OR

• Provider is affiliated with one of the following ACNs affiliated with Corewell Health East:

• BACO (Beaumont ACO)
• OPNS (Oakland Physicians Network Services)
• OMS (Olympia Medical Services)
• OSP (Oakland Southfield Physicians)
• UP (United Physicians)
• UOP (United Outstanding Physicians)
• MNO (Medical Network One)

OR

• Provider has current medical staff privileges at or refers to a Corewell Health East facility. Priority Health reserves the right to revisit the number of ACNs eligible to participate in the products as provider consolidation occurs

OR

• Ancillary provider that is owned or partially owned by Corewell Health East.

Prior authorizations are required for select services, but referrals are not

• We’re proud to be an HMO that doesn’t require an in-network referral to see a Priority Health doctor, even for specialty care. Like with other Priority Health patients, prior authorization is required for some services and procedures, including high tech imaging. To request authorizations, log in to prism and then click Authorizations, then Request an auth

• You can see patients, even if you're not listed on the ID card

• Priority Health member ID cards never list a member’s PCP. While we encourage all members to select a PCP, participating providers can still see patients even if they have not chosen a PCP.

Plans available to Corewell Health East employees

Plan name	Plan type	Network type	Who's in network	Member coverage and costs	Referrals required?
Beaumont Health Network	HMO	Narrow network	Corewell Health employed and independent doctors, mid-levels and facilities, including those in-network with Priority Health and with privileges at Corewell Health	Care in the narrow network is covered. Care outside the narrow network is not covered and the member is liable for all costs	No. Referrals to in-network specialists are not required
Beaumont Health Extended	POS	Tiered network	Tier 1: Corewell Health employed and independent doctors, mid-levels and facilities, including those in-network with Priority Health and with privileges at Corewell Health Tier 2: Everyone in the Priority Health network	Tier 1: Covered and lowest member costs Tier 2: Covered with higher member costs Out of network: Covered with highest member costs	No. Referrals to in-network specialists are not required
Beaumont Health Extended HSA	POS	Tiered network	Tier 1: Corewell Health employed and independent doctors, mid-levels and facilities, including those in-network with Priority Health and with privileges at Corewell Health Tier 2: Everyone in the Priority Health network	Tier 1: Covered and lowest member costs after deductible Tier 2: Covered with higher member costs after deductible Out of network: Covered with highest member costs after deductible	No. Referrals to in-network specialists are not required

 

Member ID card sample