:: Provider Finder ® ::
Frequently Asked Questions
  1. What is the Provider Finder?
  2. What is a provider?
  3. What types of providers are listed?
  4. What is a primary care physician (PCP)?
  5. What types of doctors serve as primary care physicians (PCPs)?
  6. Do all family members have to select the same PCP?
  7. Can I use this site to change my PCP?
  8. What information can I find using the Provider Finder?
  9. A doctor is listed in Provider Finder, but not in the printed directory I received. Which is correct?
  10. Why does the Provider Finder say my ZIP code makes me ineligible for HMO Illinois or BlueAdvantage SM HMO?
  11. How often is the Provider Finder updated?
  12. My doctor says s/he is in the Blue Cross and Blue Shield network, but I can't find him/her in the Provider Finder. Why?
  13. Can I print this FAQ?
  14. Are the fields on the Provider Finder case sensitive?
  15. I don't have a printer but I want to save the results. Can this be done?
  16. If I locate a provider on this Web site, does that mean that my visit to the provider will be paid by my health care benefit plan?
  17. Can I find a dentist on the Provider Finder?
  18. I tried to create a Personalized Directory, but the results do not display on my screen. What's wrong?
  19. I am going to be traveling abroad and would like to find a doctor in a European country, in case I need one. Can you help?
  20. What can I do if I suspect my provider is involved in fraudulent practices?
  1. Q. What is the Provider Finder?
    A. It's a tool designed to supply you with a list of providers (doctors, hospitals and other health care professionals) that contract with Blue Cross and Blue Shield of Illinois. The Provider Finder helps you search for providers by name, health plan and provider type. You can also create and print a personalized provider directory based on your search and obtain maps and driving directions to providers suitable to your location.
  2. Q. What is a provider?
    A. A provider is a health care facility, program, agency, doctor or other health professional that provides health care services.
  3. Q. What types of providers are listed?
    A. The Provider Finder lists doctors (primary care physicians and specialists), medical groups, therapists, clinics, hospitals and other health care professionals.
  4. Q. What is a primary care physician (PCP)?
    A. A primary care physician (PCP) is the physician you choose to treat and coordinate your health care needs. Not all health care benefit plans including PPO plans require a primary care physician.
  5. Q. What types of doctors serve as primary care physicians (PCPs)?
    A. A PCP can be an internist, family practitioner, general practitioner, pediatrician or obstetrician/gynecologist (OB/GYN). Depending on your health care benefit plan, a PCP may also be a certified nurse/midwife or chiropractor.
  6. Q. Do all family members have to select the same PCP?
    A. No. Each family member may select a PCP that best meets his or her individual needs.
  7. Q. Can I use this site to change my PCP?
    A. No, the Provider Finder is intended to give you a current listing of those health care providers that meet your list of selected criteria (for example, location and specialty). HMO members: To change your PCP within the same medical group that you have already selected, call the medical group to verify that the PCP (or if you are a female member, the Woman's Principal Health Care Provider) is affiliated with the group and accepting new patients. If you want to change your medical group and your PCP, contact Member Services with your new medical group selection. Point of Service and BlueChoiceŽ members: To change your PCP, call the toll-free number on the back of your ID card.
  8. Q. What information can I find using the Provider Finder?
    A. Depending upon the network and type of provider you're looking for, you can find doctor's name, ID number (for PCPs only), directory number, phone number, address, specialty and hospital and clinic affiliations. Once you have located a provider, you can obtain maps and driving directions to the location.
  9. Q. A doctor is listed in Provider Finder, but not in the printed directory I received. Which is correct?
    A. Because the Provider Finder is updated weekly, it will usually be more current than the printed directories. However, you should always check with the individual provider to verify that s/he is participating in the network before you receive services.
  10. Q. Why does the Provider Finder say my ZIP code makes me ineligible for HMO Illinois or BlueAdvantage SM HMO?
    To participate in HMO Illinois or BlueAdvantage HMO, you must live within the HMO service area. If you believe you live within the service area, retry your search, or call HMO Member Services toll free at (800) 892-2803.

  11. Q. How often is the Provider Finder updated?
    A. The product networks within the Provider Finder are updated weekly. However, you should always check with the individual provider to verify that s/he is participating in our network before you receive services.
  12. Q. My doctor says s/he is in the Blue Cross and Blue Shield network, but I can't find him/her in the Provider Finder. Why?
    A. We work diligently to keep the Provider Finder accurate and up to date. However, if your provider was not listed, it may be that your search criteria were too broad or too narrow. The Provider Finder returns the first 100 providers if you have searched by Name or by Provider Type, or the first 500 if you searched by Health Plan. You may wish to return to the Search area and be broader or more specific.

    Tips:
    • Enter fewer letters if you are unsure of the spelling.
    • If your provider is part of a group practice, search with the name or address of the group practice.
    • Your provider may not be in your specific network of doctors (with your member ID number, the provider can check their eligibility).
    • If your provider has recently contracted with Blue Cross and Blue Shield, they may not appear in the network yet. Contact the Member Services "800" number located on the back of your Blue Cross and Blue Shield of Illinois ID card to see if they are in the network.
  13. Q. Can I print this FAQ?
    A. Yes, you can use your Internet browser to print this page, just like any other Web page. How you do this will depend on the Internet browser you use. See your Internet browser's help documentation for more information.
  14. Q. Are the fields on the Provider Finder case sensitive?
    A. No, you can use either upper or lower case when entering information.
  15. Q. I don't have a printer but I want to save the results. Can this be done?
    A. Once the directory appears on your screen, save it by selecting the save icon on the toolbar above your directory, then select the location on the computer where the copy will be saved.
  16. Q. If I locate a provider on this Web site, does that mean that my visit to the provider will be paid by my health care benefit plan?
    A. This site is only a provider locator service, so you may not have coverage for services provided by all types of providers listed. Review your benefit booklet for the benefits covered under your health care benefit plan as we do not have information about benefits or payment levels available on the Provider Finder. If you have additional questions about your coverage, please call the customer service number on your member ID card.
  17. Q. Can I find a dentist on the Provider Finder?
    A. Yes, dentists are listed in the Provider Finder. Check your benefit booklet or contact the customer service number listed on your member ID card to determine your dental network. Remember that members receive the highest level of benefits when they visit an in-network dentist.
  18. Q. I tried to create a Personalized Directory, but the results do not display on my screen. What's wrong?
    A. You will need the Adobe Acrobat Reader to view these results. If you do not have this software, you can go to the Adobe Web site and download it for free. If you have created a personalized directory with more than 100 providers by using the Search by Name or Provider Type, or created a directory of more than 500 if you Searched by Health Plan, you will need to enter an e-mail address for it to be sent to you.
  19. Q. I am going to be traveling abroad and would like to find a doctor in a European country, in case I need one. Can you help?
    A. The BlueCard Worldwide program provides Blue Cross and Blue Shield eligible members with access to a network of hospitals and doctors worldwide. Log on to the BlueCard Worldwide Web site to find participating providers and other information that is important to know before you travel.
  20. Q. What can I do if I suspect my provider is involved in fraudulent practices?
    A. You can report suspected fraud with complete confidentiality to the Blue Cross and Blue Shield National Anti-fraud Hotline number. Call: (877) 327-BLUE (2583).