Where do you go to find a new doctor when you move? Or perhaps you are traveling or on vacation and you misplaced your medication. Where do you go to find a Preferred pharmacy to refill your prescription? Maybe you want to check out the specialist your primary care physician has referred you to for treatment of your diabetes. The online Provider Directory on our web site can help you with these questions and more.
Why Use Preferred Providers?
Knowing the providers in our national Preferred network is important to you for one big reason — money. You save money when you use Preferred physicians, hospitals, pharmacies and other professional health care providers because your out-of-pocket expense is less. It is also convenient to use Preferred providers since they will file any necessary claims to us. You don't have to pay for covered charges upfront, except for any deductibles, coinsurance, or copayment amounts in some instances.
Locating Preferred Providers
If you have been seeing the same physician for years, you may not have needed to use or realized the value of information in our online Provider Directory. Accessing and using the Provider Directory is easy. And it is available 24 hours a day, seven days a week, so it is convenient for you to use when you need information.
First, click on the Provider Directory button on our homepage to access the Provider Selection Advisor. This first page gives you lots of options. Our focus for this article will be the Standard Option Advisor and the Basic Option Advisor. You can search for providers in English and Spanish. Your first step is to click on the button that indicates your coverage, Standard Option or Basic Option. Next, click on the button for the type of provider you are looking for in the directory. If you know the name of the provider you are looking up in the directory, we will cover that below.
Once you select the type of provider you are seeking and have clicked that button, a search screen will appear asking the name of the provider, the location, and provider specialty.
- You should enter all the information you know.
- Then click on the NEXT button for the name, if you entered that information, even if you also entered location and/or specialty.
- If you are searching for a provider in a specific location, but don't know a name, enter your location then click the NEXT button in the location box.
- After you click the NEXT button, a new screen will appear that confirms the information you entered and allows you to edit or add information as well.
- When this information reflects the information for your search, click on the GET YOUR RESULTS button.
- The results of your search will appear.
When you know the name of the provider you are looking for in the search, you can enter the information on the first page of the Provider Directory and click on the NEXT button. A page confirming your information will appear, allowing you to edit or add information for your search. The results of your search will appear when you click on the GET YOUR RESULTS button.
Physician Information
Your search results will provide information about the physicians that meet your search criteria. This includes the physician's name, address and phone number. You will also be able to see how far the physician is from the location entered in your search, if the physician speaks a second language, if the physician is accepting new patients, the gender of the physician and any recognition from health care organizations.
There is also a set of buttons across the top of the search results:
- Affiliations indicates the hospitals where the physician has privileges
- Credentials shows the education and training of the physician
- Recognitions lists recognitions by health care organizations
- Other Information provides information about extended and weekend office hours, any patient age or gender restrictions, and wheelchair accessibility
Hospital Information
The results of your hospital search will also give you the hospital's address and phone number. In addition, there is a COMPARE button that allows you to compare other hospitals in the area to your search results. Clicking on this button directs you to the Hospital Advisor, which is discussed in another Media Room article this month.
The information on the search results page provides information about the hospital's:
- Patient Safety, indicating the hospital's progress toward implementing 27 recommended safety practices that reduce the risk of harm to patients
- Surgical Complications, using publicly recorded data for the hospital's performance related to the reduction of certain complications
- Infection Prevention, using Centers for Medicare and Medicaid or CMS standards of performance to measure health outcomes for patients
There are also four buttons at the top of the search results information:
- Blue Distinction recognizes facilities that deliver quality health care based on objective criteria for certain conditions, including transplants, bariatric surgery, cardiac care and complex and rare cancers. This feature will indicate if the hospital is a Blue Distinction Center for these conditions.
- Surgical Complications uses a measure developed by WebMd to show a hospital's performance related to complications involving medical care, surgical care, OB care and pediatric care.
- Process Measures for heart attack, heart failure, pneumonia, and infection prevention uses CMS standards to track the hospital's performance in the patient outcomes related to these conditions.
When you know how to use the Provider Directory, you can get the information you want to meet your health care needs. If you make a mistake or forgot to enter some information, the Provider Directory feature will always let you go back to edit, add or remove information.
We hope you will take some time to check out the online Provider Directory.