SmartHealth Exclusive Provider Organization (EPO) plan

Welcome to the new SmartHealth Exclusive Provider Organization (EPO) plan, For eligible associates who are part of Ascension Kansas. This is a new plan that is designed to offer more predictable expenses and better coordination of care. As an EPO member, here is what you need to remember about the plan:

Services are covered only if you visit doctors, specialists, or sites of care in the Ascension Network (except in an emergency). This includes labs and tests.

To find a provider, navigate to the "Find a Doctor" tab above. Be sure to check that they are a participating Ascension SmartHealth Tier 1 Network provider and facility before you schedule your appointment. 

If you seek care out of the Ascension Network without an approved referral, you will be responsible for the full cost of care. Urgent care, behavioral health and substance abuse visits, as well as medical emergencies, will be covered through any provider, without a referral.

Click here to see a list of services that require prior authorization.

Medical ID cards

Members on this plan will receive two separate medical ID cards, one from SmartHealth and the other from Blue Cross Blue Shield.

Use your SmartHealth EPO medical ID card:

• When you receive care in the Ascension Network.
• View sample card here.

Use your Blue Cross Blue Shield medical ID card:

• If a service is not available through the Ascension Network, and you have a referral, submitted by your Ascension Network provider, and approved by SmartHealth.
• View sample card here.

Prescription ID card

You will receive a prescription ID card from MaxorPlus. Use this when you have a prescription filled at your preferred pharmacy.

Member resources

• Appeal process
• Post service and second level appeal request form
• Schedule of Benefits - 2024
• Summary of Benefits and Coverage - 2024
• 2023 EPO Summary Plan Description

Provider resources

Any service performed outside of the Ascension Network will be considered out of network and not covered. If a service is unavailable in the Ascension Network, the Ascension Network provider must submit a referral to SmartHealth. Referrals must be within the Blue Cross Blue Shield Network.

• How to obtain a referral
• Referral form
• List of services requiring prior authorization
• How to submit prior authorization requests
• Provider portal training video
• Prior authorization form

Still have questions about the EPO plan?

Please view these FAQs, or call customer service at 888-492-6811