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Aetna Network Update - July 13, 2012

North Jersey Primary Care (NJPC) located in Hackensack, NJ may terminate from our New Jersey Aetna network effective August 15, 2012
 
Highlights
• NJPC is the faculty practice providing services at Hackensack University Medical Center.
• NJPC consists mostly of specialists and sub specialists.
• We continue to negotiate with NJPC in an effort to reach agreement on a contract.
• There were no network adequacy issues identified as a result of the termination.
 
Physician Group Locations
Hackensack University Medical Center
30 Prospect St.
Hackensack, NJ 07601
                       
There are 360 participating physicians who are affiliated with North Jersey Primary Care. A listing of these physicians is included in this communication. 
 
North Jersey Primary Care may terminate their contract for the following product(s):
• HMO
• Aetna Open Access® HMO
• Quality Point-of-Service® (QPOS®)
• Aetna Choice® POS
• Aetna Medicare Plan (HMO)
• Aetna Medicare Plan (PPO)
• Managed Choice® POS
• Aetna Choice® POS II
• Aetna Open Access® Managed Choice® POS
• Elect Choice® EPO
• Aetna Open Access® Elect Choice® EPO
• Aetna Select
• Open Access Aetna Select
• Open Choice® PPO
• Aetna Healthfund®
 
Member letters
We will send letters to the following employees and their dependents:
• Employees and their dependents who have been treated by a Primary Care Physician at least once in the past 12 months.
• Employees and their dependents who have selected a Primary Care Physician.
• Employees and their dependents who have been treated by a specialist provider at least twice in the past 12 months.
 
We will help with transition of care
Aetna’s standard transition of care policy will apply to members actively in a course of treatment. If any of your employees will require frequent or continuing consultation with a specialist physician for ongoing covered care, the employee should contact his or her current PCP who can help arrange transfer of that care to a similar specialist in the Aetna network.  If the member does not have a relationship with a PCP, the member should check DocFind® and other available resources to help find another specialist in the Aetna Network.  For a limited time and when appropriate, Aetna will cover certain ongoing medical care for a serious illness for a specified period at the preferred level of benefits, rendered by a specialist who no longer participates in the network.
 
DocFind/directory information
We will remove North Jersey Primary Care from our DocFind® online directory at the next scheduled update, after the contract is terminated.  Current printed provider directories include North Jersey Primary Care. This Physician Group will be removed from the next directory edition. DocFind is updated nightly, and is the most current source of participating physician and hospital information.
 
Posted: 7/16/2012 1:54 PM