How We Choose Providers for Our Networks

Blue Cross and Blue Shield of Illinois (BCBSIL) checks the locations of all health providers in all of our networks to help ensure our members have access to in-network providers. BCBSIL wants to help ensure in-network providers are available and accessible to members. We do not use member experience, quality or cost-related measures to choose providers for our networks.

Medical Providers

BCBSIL works to contract with providers that offer services in all areas of medicine, including:

  • Family Practice
  • General Practice
  • Chiropractic Practice
  • Internal Medicine
  • Specialty
  • Subspecialty
  • General and specialty surgery
  • Rehabilitation

Behavioral Health Providers

In-network behavioral health providers provide the following services:

  • Psychiatry
  • Clinical Psychology
  • Licensed Clinical Social Work
  • Licensed Counseling, including Clinical Counseling and Marriage and Family Therapy

*This is not a complete list of in-network behavioral health provider specialties.

Your BCBSIL plan may use a tiered network. Based on cost, providers are placed into two tiers:

Tier 1: Members get the highest level of benefits and pay the lowest out-of-pocket costs
Tier 2: Members get a reduced level of benefits and pay higher out-of-pocket costs

How BCBSIL Chooses Hospitals

We check the locations of all hospitals in all of our networks to help ensure our members have access to in-network hospitals. BCBSIL wants to help ensure hospitals are available and accessible to members. We do not use quality, member experience or cost-related measures to choose hospitals for our networks.

Your BCBSIL plan may use a tiered network. Based on cost, hospitals are placed into two tiers:

Tier 1: Members get the highest level of benefits and pay the lowest out-of-pocket costs
Tier 2: Members get a reduced level of benefits and pay higher out-of-pocket costs

 

 

Last Updated: June 17, 2021