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If you're not satisfied with your current Primary Care Physician (PCP) through Blue Cross Blue Shield (BCBS), it's time to make a change. You can switch to a new PCP within your network to get better healthcare.
Research shows that having a good relationship with your PCP is crucial for your overall health and well-being. In fact, studies have shown that patients who are satisfied with their PCP are more likely to stick to their treatment plans and have better health outcomes.
BCBS allows you to switch PCPs at any time, and you can choose from a network of thousands of doctors and specialists.
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Choosing a New PCP
You can change your Primary Care Provider (PCP) as many times as you need to, and it's easy to do. Just call Member Services at 1-877-860-2837 (TTY/TDD: 711) and they'll take care of it.
When searching for a new PCP, think about logistics. You'll want to find a doctor with an office location that's convenient for you, and office hours that fit your schedule.
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Consider what hospital your PCP admits patients to, and whether you'll need to take time off work to visit the office. It's also a good idea to check what languages your PCP speaks, so you can communicate clearly with them.
You can use the Provider Finder's "advanced search" feature to find in-network doctors who speak Spanish or other languages.
Think About Logistics
When selecting a new primary care physician, think about logistics to ensure a smooth and convenient experience. Consider the doctor's office location - is it close to your home or office, making it easier to visit?
You'll also want to check the doctor's office hours, including the days and times they see patients. This will help you plan your schedule and avoid taking time off work to visit the office.
Language is another important factor to consider. Look for doctors who speak the language you're most comfortable with, so you can communicate clearly with them.
Many doctors now use email or online portals to communicate with patients, which can be a convenient option for tech-savvy individuals.
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Primary Care Provider
Choosing a New PCP? Here's What You Need to Know.
You can change your Primary Care Provider (PCP) as many times as you want, and it's completely free. Just give Member Services a call at 1-877-860-2837 (TTY/TDD: 711) to make the switch.
To find a new PCP, use our Provider Finder tool to search for doctors and other providers.
If you're unsure about your current PCP, you can reach out to Member Services and they'll be happy to help you coordinate your health care needs.
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Access Your Benefits
To access your benefits, find your local BCBS company to ask a question, change your coverage, or view your plan details. They'll be able to guide you through the process.
The Blue Cross Blue Shield Association is a national federation of independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans.
If you're enrolled in a POS plan, your PCP plays a crucial role in obtaining in-network benefits from Health Advantage.
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Finding a Doctor
Finding a doctor can be a daunting task, especially when you're changing primary care physicians. To make the process smoother, start by determining which doctors are "in-network" with your insurance plan. This will help you avoid surprise charges or having to pay out-of-pocket for a doctor who doesn't accept your insurance.
You can find in-network doctors by checking your insurance plan's directory. Once you have a list of in-network doctors, you can start narrowing it down by considering their expertise and specialties. For example, family practice physicians can treat patients of all ages, while internal medicine physicians specialize in treating adults and managing chronic conditions.
If you're still unsure, ask for referrals from friends, family, or other healthcare professionals. They may be able to recommend a doctor who meets your needs.
Determine In-Network Doctors
Most health plans have negotiated special, discounted rates with certain doctors and hospitals in your area.
You'll pay less out of pocket for visiting these doctors, who are called "in-network" for insurance purposes.
You can check your insurance plan's directory to find an in-network doctor in your area.
Selecting an in-network doctor will help you avoid a surprise "out-of-network" charge or having to pay in full out-of-pocket because the doctor you've selected doesn't accept your insurance plan.
Find a Doctor with Expertise That Meets Your Needs
Finding a doctor with the right expertise can be a daunting task, but it's essential to ensure you get the best care for your specific needs. You've got a list of in-network doctors to choose from, now it's time to narrow it down.
Family practice physicians are generalists who can treat patients of all ages, from newborns to the elderly, and often can also treat ailments you'd normally see a specialist for.
Internal medicine physicians typically treat adults and specialize in the prevention, diagnosis, and management of disease and chronic conditions. This is a good choice if you're looking for a doctor who can help you manage long-term health issues.
General practice physicians are like family practice physicians and can treat patients of any gender or age. They might also include osteopaths, who practice a type of alternative medicine with a special focus on the musculoskeletal system.
If you have children, you'll want to look for pediatricians, who are doctors that specialize in the care of infants, children, and adolescents.
Here are the different types of doctors you might find as primary care physicians:
- Family practice
- Internal medicine
- General practice
- Pediatrics
Ask for Referrals
Asking for referrals is a great way to find a doctor you'll feel comfortable with. Many people visit doctors recommended by friends and family, so ask around and see who they visit.
You can also ask another healthcare professional you have a relationship with, like a pharmacist or dentist, for a recommendation. They may have a good idea of who's good in the area.
If you're moving to a new location, ask your current doctor if they have a recommendation for your new area. They may know of a good doctor in the area you're moving to.
Practice Details
When finding a doctor, it's essential to consider the practice details. The hours of operation can make a big difference, so you may want to look for a practice that offers evening or Saturday hours for more convenience.
Some practices may also offer telehealth visits, allowing you to see a doctor remotely. This can be a great option if you have a busy schedule or live far from the office.
An online patient portal can be a valuable resource, enabling you to access your medical records and communicate with your doctor from home.
In addition to the medical staff, some practices may have other professionals on site, such as a registered dietitian or physical therapist. This can be beneficial if you need specialized care.
Convenient services like on-site x-rays or in-house lab testing can also make a practice more appealing.
Here are some key features to consider when evaluating practice details:
- Evening or Saturday hours
- Telehealth visits
- Online patient portal
- Additional providers on site (e.g. registered dietitian, physical therapist)
- Convenient services (e.g. on-site x-rays, in-house lab testing)
Sources
- https://connect.bcbsil.com/ask-bcbsil/w/frequently-asked-questions/65/how-to-update-your-pcp-or-medical-group
- https://www.bcbs.com/news-and-insights/article/five-tips-choosing-new-primary-care-physician
- https://www.bcbsil.com/bcchp/resources/faqs
- https://www.healthadvantage-hmo.com/members/employer-coverage/member-rights/your-primary-care-physician
- https://www.bluecrossvt.org/health-community/blog/listing/choosing-primary-care-provider-whos-right-me
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