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What
is the Provider Finder?
The Blue Cross and Blue Shield of
Illinois Provider Finder is designed
to give a listing of providers from
our networks considering your specific
needs. You'll be able to search for
providers in your area, or find a
specific provider by name, as well
as create and print a customized provider
directory based on your search. You
can also use Provider Finder to obtain
maps and driving directions to providers
convenient to your location.
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What
is a provider?
Providers are health care professionals
that Blue Cross and Blue Shield of
Illinois have contracted with to assist
you with your medical care needs.
A provider can be a Physician, Medical
Group, Hospital or Clinic.
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What
types of Providers are listed?
The Blue Cross and Blue Shield of
Illinois Provider Finder lists physicians,
Medical Groups, clinics and hospitals.
Physicians may include both Primary
Care Physicians as well as specialists
depending on the network you are viewing
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What's
a Primary Care Physician (PCP)?
For HMO Illinois and BlueChoice,
a Primary Care Physician (PCP) is
the physician you choose to be your
primary source for medical care. Your
PCP coordinates all your medical care,
including hospital admissions and
referrals to specialists.
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What
types of doctors serve as Primary Care
Physicians (PCPs)?
Medical providers that serve as PCPs
are Family Practitioners, General
Practitioners, Internists, Pediatricians
and OB/GYNs.
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Do
all family members have to select the
same PCP?
No. Each family member may select
a PCP that best meets his or her individual
needs.
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Can I use this site to change my PCP?
No. Provider Finder is intended to
give you a current listing of those
health care providers that meet your
list of selected criteria (location,
specialty, etc.). To change your PCP,
please contact the Member Services
"800" number located on
the back of your Blue Cross and Blue
Shield of Illinois membership ID card.
You should always verify that the
physician is participating in our
network before you receive services.
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What
information can I find using Provider
Finder?
Depending upon the network and type
of provider you're looking for, Provider
Finder offers you several forms of
useful information on health care
professionals. These may include the
doctor's name, ID# (for PCPs only),
directory number, phone number, address,
specialty, hospital and clinic affiliations.
Once you have located a provider,
you can obtain maps and driving directions
to the location.
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Why
does Provider Finder need to know my
address?
If you simply want to look up the
name of a particular physician, you
need not enter your address information
at all. However, the Blue Cross and
Blue Shield of Illinois' Provider
Finder is also intended to locate
health care providers convenient to
a location--home, office, or child's
school. Without providing your address,
we have no way of selecting appropriate
providers from among the thousands
in our health care networks.
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I
don't know my doctor's address, so how
do I use Provider Finder?
You don't need to know your physician's
address to use Provider Finder. Provider
Finder is used to locate health care
providers convenient to your location,
whether that means your home, office,
or child's school. Please use those
addresses in Provider Finder to retrieve
a list of providers nearest you.
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If
a doctor is not in the printed directory
I received but is on Provider Finder,
which is correct?
Because Provider Finder is updated regularly, it will usually be more current than the printed directories. However, you should always check with the doctor to verify that he or she is participating in our network before you receive services.
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Why
does Provider Finder say my zip code
makes me ineligible for HMO Illinois?
To participate in HMO Illinois, you
must live within the HMO Illinois
service area. If you believe you meet
this criteria, you may wish to retry
your search, or call the HMO Illinois
Member Services number at 1-800-892-2803.
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How
often is Provider Finder updated?
All the product networks within the Provider Finder are updated weekly. However, you should always check with the doctor to verify that he or she is participating in our network before you receive services.
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What
if I can't find my physician in the
Provider Finder database?
Every effort is made to ensure Provider
Finder is complete and accurate. However,
if your provider was not listed as
a member in one of our provider directories,
it may be that your search criteria
was too broad. Provider Finder only
returns the first 100 providers based
upon your search criteria. You may
wish to return to the Search area
and be more specific. If you are still
unable to find the name of your provider,
please contact the Member Services
"800" number located on
the back of your Blue Cross and Blue
Shield of Illinois membership ID card,
or contact your employer's benefits
representative.
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