Network Selection Criteria for Doctors and Hospitals

Network Selection Criteria for Doctors

BCBSIL does not use quality measures, member experience measures or cost-related measures to select practitioners for participation in the BCBSIL Marketplace plans. BCBSIL evaluates its Marketplace networks and takes into consideration the geographic distribution of medical and behavioral health providers to ensure that BCBSIL members have access to participating providers within federal and state availability and accessibility standards.

The medical provider specialty types available in these BCBSIL networks include, Allergy / Immunology, Cardiology, Dermatology, Endocrinology, Family Practice, Gastroenterology, General Practice, General Surgery, Neurology, Neurosurgery, Obstetrics & Gynecology, Oncology/Radiation, Ophthalmology, Orthopedic Surgery, ENT/Otolaryngology, Urology, Chiropractor, Internal Medicine, Infectious Disease, Nephrology, Pediatrics, Physiatry /Rehabilitative, Plastic Surgery, Pulmonary, Rheumatology

The behavioral health specialty types available in these BCBSIL networks include, Psychiatry (including Psychiatry, Child Adolescent Psychiatry and Geriatric Psychiatry), Clinical Psychology, Licensed Clinical Social Worker, Licensed Counselor (including Licensed Professional Clinical Counselor and Licensed Marriage and Family Therapist).

Network Selection Criteria for Hospitals

BCBSIL does not use quality measures, member experience measures or cost-related measures to select hospitals for participation in the BCBSIL Marketplace plans. BCBSIL evaluates its Marketplace networks and takes into consideration the geographic distribution of hospitals to ensure that BCBSIL members have access to participating hospitals within federal and state availability and accessibility standards.