:: Provider Finder ® ::
Frequently Asked Questions
  1. Can I print this FAQ?
  2. Are the fields on the Provider Finder case sensitive?
  3. What is the Provider Finder?
  4. What information can I find using the Provider Finder?
  5. If I locate a provider on this Web site, does that mean that my visit to the provider will be paid by my insurance plan?
  6. How often is the Provider Finder updated?
  7. Can I find a dentist on the Provider Finder?
  8. What is a provider and how are they listed?
  9. A doctor is listed in Provider Finder, but not in the printed directory I received. Which is correct?
  10. My doctor says they are in the Blue Cross and Blue Shield of Texas network, but I can't find them in the Provider Finder. Why?
  11. I don't have a printer but I want to save the results. Can this be done?
  12. I tried to create a Personalized Directory, but the results do not display on my screen. What's wrong?
  13. What is an ancillary service?
  14. What is a Primary Care Physician (PCP)?
  15. What types of doctors serve as Primary Care Physicians (PCPs)?
  16. Do all family members have to select the same Primary Care Physician (PCP)?
  17. Can I use this site to change my PCP?
  18. What is PPO coverage?
  19. What is Traditional coverage?
  20. What is POS coverage?
  21. What is the BlueCard Program?
  22. 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?
  23. What can I do if I suspect my provider is involved in fraudulent practices?
  24. What is BlueCompare?
  1. 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.
  2. Q. Are the fields on the Provider Finder case sensitive?
    A. No, you can use either upper or lower case when entering information.
  3. Q. What is the Provider Finder?
    A. It's a tool designed to supply you with a listing of providers (doctors, hospitals and other health care professionals) in the Blue Cross Blue and Shield of Texas networks. The Provider Finder helps you search for providers by name, health plan/network 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.
  4. Q. What information can I find using the Provider Finder?
    A. Depending upon the network and type of provider you're looking for, the Provider Finder offers several forms of useful information on health care providers. These may include the doctor's name, ID number (for Primary Care physicians [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. For BlueChoice providers, you can also find BlueCompare information on Affordability, Evidence Based Measures and Hospital Performance.
  5. Q. If I locate a provider on this Web site, does that mean that my visit to the provider will be paid by my insurance 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 plan as information about benefits or payment levels is not available on the Provider Finder. If you have additional questions about your coverage, please call the customer service number on your member ID card.
  6. Q. How often is the Provider Finder updated?
    A. The networks within the Provider Finder are updated daily. However, you should always check with the individual provider to verify that s/he is participating in your network before you receive services.
  7. Q. Can I find a dentist on the Provider Finder?
    A. Yes, dentists are listed in the Provider Finder. To determine which network your health plan is with, check your benefits booklet or contact the customer service number listed on your member ID card. Remember that members receive the highest level of benefits when they visit an in-network dentist.
  8. Q. What is a provider and how are they listed?
    A. Providers are health care professionals that Blue Cross and Blue Shield of Texas have contracted with to assist you with your medical care needs. The Provider Finder lists doctors, medical groups, clinics, hospitals and ancillaries. Doctors may include both Primary Care Physicians (PCP) as well as specialists depending on the health plan/network you are viewing.
  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 regularly, 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 your network before you receive services.
  10. Q. My doctor says they are in the Blue Cross and Blue Shield of Texas network, but I can't find them in the Provider Finder. Why?
    Every effort is made to ensure that the Provider Finder is complete and accurate. 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 500 providers based upon your search criteria. You may wish to return to the Search area and be more specific or more broad with your search criteria.

    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 of Texas, they may not appear on our networks yet. Contact the Member Services "800" number located on the back of your Blue Cross and Blue Shield of Texas ID card to see if they are in the network.
  11. Q. I don't have a printer but I want to save the results. Can this be done?
    A. Once the directory is shown on your screen, save by selecting the save icon on the toolbar above your directory, then select the location on the computer where the copy will be saved.
  12. 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 over 500 providers, you will need to enter an e-mail address for it to be sent to you.
  13. Q. What is an ancillary service?
    A. Ancillaries include the following types of services:
    • Ambulatory Surgery Centers
    • Audiologist
    • Durable Medical Equipment
    • Hearing Aid Services
    • Home Infusion Therapy
    • Hospice
    • Imaging Centers
    • Labs
    • Mobile Laser
    • Occupational Therapists, Physical Therapists, Speech Therapists
    • Physical Rehab Hospitals
    • Prosthetics & Orthotics
    • Radiation Therapy Centers
    • Renal Dialysis Centers
    • Skilled Nursing Facilities
    • Urgent Care Facilities
  14. Q. What is a Primary Care Physician (PCP)?
    A. A PCP is the doctor you choose to be your primary source for medical care and will coordinate all of your medical care, including hospital admissions and referrals. If you have health maintenance organization Health Maintenance Organization (HMO) or point of service Point of Service (POS) coverage you will be required to have a PCP on file, check your benefit booklet for more information on PCPs.
  15. Q. What types of doctors serve as Primary Care Physicians (PCPs)?
    A. Medical providers that serve as PCPs are Family Practitioners, General Practitioners, Internists, Pediatricians and OB/GYNs.
  16. Q. Do all family members have to select the same Primary Care Physician (PCP)?
    A. Each family member may select a PCP that best meets his or her individual needs.
  17. 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 (location, specialty, etc.). To change your PCP, please call the Member Services "800" number located on the back of your Blue Cross and Blue Shield of Texas ID card. You should always verify that the doctor is participating in your network before you receive services.
  18. Q. What is PPO coverage?
    A. A PPO is a preferred provider health benefit plan, a health care plan that provides covered services at a discounted cost for subscribers who use network health care providers. PPOs also provide coverage for services rendered by health care providers who are not part of the PPO network; the subscriber generally pays a greater portion of the cost for such services.
  19. Q. What is Traditional coverage?
    A. Traditional coverage is a health benefit product that gives members coverage for various services. Traditional coverage usually includes a deductible or copayment.
  20. Q. What is POS coverage?
    A. POS means Point of Service, a type of health care plan which requires subscribers to select a primary care physician (PCP) who will coordinate all medical care. Point of Service plans allow subscribers to go outside the health plan's provider network for care, but require subscribers to pay higher out-of-pocket fees when they do so.
  21. Q. What is the BlueCard Program?
    A. The BlueCard program allows eligible members to enjoy the same level of benefits whether they are traveling or at home. To determine eligibility call the customer service number listed on the back of your membership ID card.
  22. 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 of Texas eligible members with access to a network of hospitals and doctors and assistance in obtaining medical care worldwide. Log on to the BlueCard Worldwide Web site to find providers and other information that is important to know before you travel.
  23. 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. That number is (877) 327-BLUE (2583).
  24. What is BlueCompare
    A. BlueCompare is a tool that provides helpful information about doctors and hospitals in our preferred provider organization (PPO) networks. BlueCompare for Physicians uses our claims and member data to help you compare doctors on quality-related and cost efficiency performance. BlueCompare for Hospitals uses data that hospitals report to help you compare hospitals in two ways: Performance Measures and Affordability. BlueCompare is not designed to tell you which provider you should select. This is a very personal choice, and you should not decide based on BlueCompare information alone.