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 Resource Management, Inc. (Medicus) 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.