2023 Ambetter Virtual Access

Date: 07/26/22

As a valued Ambetter provider, we’re excited to share that you’ve been selected to participate in the new Ambetter Virtual Access provider network. Ambetter Virtual Access provides you with exclusive access to a population of potential patients seeking a streamlined continuum of care that simplifies their healthcare journeys.

Ambetter Virtual Access features a PCP-centric approach to care delivery. Primary care physicians (PCPs) coordinate our members’ medical care, as appropriate, either by providing treatment or by issuing referrals to other in-network providers. For services to be covered, they must be provided by or referred by a PCP. The only exclusions from this requirement are emergency care, urgent care, and in-network mental health, behavioral health, and obstetrical or gynecological services.

Ambetter Virtual Access provides adult members (ages 18+) with unlimited virtual primary care services for both medical and behavioral health benefits through Babylon. This simplifies members’ healthcare journeys by offering:

• A PCP-Centric Network: Members are automatically assigned to a Virtual Babylon PCP upon enrollment but may subsequently switch to a different Virtual Babylon PCP or a traditional (in-person) in-network PCP, if they wish.
• Trusted Referrals for Care: PCPs help navigate care needs by providing appropriate referrals to other in-network providers for any other non-virtual care services that are needed, excluding emergency or urgent care services. Referrals are also not required for in-network mental or behavioral health services, obstetrical or gynecological services.

Ambetter Virtual Access is expected to go live in your state on January 1, 2023. Your current network participation agreement with Ambetter from Nebraska Total Care grants you automatic participation in this new network, so there is no action needed on your part at this time. Once live, you may receive referrals from other Ambetter Virtual Access providers or be selected as a PCP by an Ambetter Virtual Access member.

Over the coming months, we’ll share more information and resources to help you prepare to see Ambetter Virtual Access members alongside your regular Ambetter members. If you have any questions about Ambetter Virtual Access, please call 833-890-0329.