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Berkshire Health Partners (BHP) Frequently Asked Questions

Why is BHP's local presence so important?

As a locally operated organization, our knowledge of the local companies, large corporations and small businesses, help us recognize the concerns and requirements of their employees. Long-term relationships with local healthcare providers and hospitals, assure our members that they will receive excellent healthcare in their home communities.

What is a provider, and how many are included in BHP's network?

A provider is a hospital, physician, healthcare facility, or other medical professional that has contracted with BHP to provide services at negotiated fees. The BHP network includes 3900+ physicians, 460+ ancillary providers such as medical equipment suppliers and home healthcare agencies, and 15 hospitals located in Berks, Upper Bucks, Carbon, Northern Lancaster, Lehigh, Montgomery, Northampton, and Schuylkill counties.

Where can I obtain a list of participating physicians?

Click here to verify that your physician is in BHP's network, or to view and print a complete list of BHP providers.

What is a primary care physician?

A primary care physician is a doctor who serves as your first contact with the medical system. A primary care physician also is called a personal care physician or primary care provider.

What is BHP's relationship with insurance companies and Third-Party Administrators (TPA's)?

BHP provides network access and Medicus, A Health & Lifestyle Management Company provides medical management services for our members. Medicus sends recommendations for care to you, your providers, and your insurance company or TPA. Final authority for determining whether a requested procedure and/or admission will be covered rests with your insurance company or TPA. Please verify your benefits before receiving any medical treatment.