Find a Provider: Choosing the right primary care doctor

One of the most important decisions you make regarding your health care is your choice of primary care physician.
Blue Shield calls them Personal Physicians.

Your Personal Physician serves as a central source for all aspects of your health needs. In addition to treating existing medical conditions, this physician monitors your health over time. He or she helps identify changes that could signal the onset of a disease. And, because primary care physicians look at the broad picture, including your lifestyle and family history, they can help plan the best ways for you to stay healthy and lead a long, productive life.
Your Personal Physician
There are several types of physicians who provide primary care. They all offer the benefits of a personal relationship based upon thorough knowledge of an individual patient. All have completed extensive training (in addition to medical school) and provide a wide range of healthcare services.

• Family and general medicine physicians provide comprehensive care for all family members, from newborns through older adults.

• Internal medicine physicians specialize in meeting the complete healthcare needs of adults, from teenagers through seniors, providing both primary and advanced levels of care.

• Obstetrician/gynecologists often serve as primary physicians for women, performing routine physicals and health screenings in addition to obstetrical and gynecological care.

• Pediatricians are experts in primary care for children, usually from infancy through the teen years.

When selecting a Personal Physician, you should keep in mind that you have the option of choosing a single Personal Physician for your entire family or selecting a different Personal Physician for yourself and each of your covered dependents. Also, your dependents’ Personal Physician can be in the same medical group as your Personal Physician or in a different medical group.
If at any time you require specialized care for a medical condition – such as a cardiologist for a heart ailment – your primary care physician will manage your overall health in conjunction with this specialist. He or she will also provide follow-up care after specialized treatment concludes.

What to look for in a physician
It takes a little homework and determination to find a personal doctor. Many people find a physician through word of mouth –asking their friends, neighbors or relatives. But your healthcare needs and personal preferences may differ from theirs.
The best way to determine if a physician is right for you or your family is to do some research. Only you know the health history, lifestyle and insurance coverage of you and your family. Only you can determine what is important to you about your own medical care provider.
Following are some questions you should ask yourself in choosing a Personal Physician:

• Is the doctor’s practice close to home? Close to work? Which do you prefer?

• Does the doctor have admitting privileges at your preferred hospital?

• Where are lab services performed? Will you have to go to an outside laboratory?

• How long must you wait for an appointment after your call?

• Do you have any language or gender preferences for your doctor?

• Is the office staff friendly and courteous?

• What are the practice’s arrangements for after-hours care needs?

Finding the right physician
The quickest and easiest way to find up-to-date listings of CCPOA Medical Plan doctors and hospitals is through the Find a Provider tool at blueshieldca.com. That’s where you’ll find detailed listings of general practitioners, specialists, hospitals, mental health providers, optometrists, acupuncturists, chiropractors, and network pharmacies. And you can easily narrow your search by location, gender, and language preferences.

As a CCPOA Medical Plan member, follow these easy online steps to find a network doctor:

1. Go to blueshieldca.com.
2. If you are not already registered, click register now in the box labeled I’m a member and enter your member ID number and your birth date.
3. Once logged in, click the Find a Provider tab at the top of the page.
4. On the next page, click the blue box for the type of provider you want to find.
5. Under Choose a Search Type and Enter Criteria, enter the type of provider you are searching for from the drop-down menu. You may also search by provider name, or condition or procedure.
6. Under Select Your Provider Preferences enter any gender or language preferences you have.
7. Under Enter Your Location, your home address information should already appear, simply enter the radius for which you’d like to search.
8. Click the Search button and the system will bring up a listing of doctors that meet your specifications.
9. On the search results page, you can also click on the links to Create a Print Directory or use the check boxes and Compare button to see a table of provider features side by side.
10. Be sure to find out if the doctor you choose is accepting new patients. Blue Shield updates their Web site frequently to give you the most up-to-date information possible. Even so it’s always best to phone the physician’s office and ask about becoming a new patient.
11. If you don’t have access to the Internet or have difficulty using the site, simply call the  Member Services phone number listed on your CCPOA Medical Plan member ID card for help selecting a provider or to get a printed directory of network providers.
    

Checking provider quality
Blue Shield is now making it easier for you to choose the right provider. By going to the Find a Provider section of blueshieldca.com, you can access quality and efficiency indicators, and patient satisfaction scores for HMO medical groups and hospitals through the Performance Profile. Because you should have the facts when making important care decisions, our Performance Profile tool provides insight into performance based on nationally recognized quality measures.

Your first appointment
We highly recommend that you don’t wait until you get sick to meet your Personal Physician for the first time. Call your Personal Physician to schedule a new patient appointment as soon as possible. Your Personal Physician needs to get to know you and your medical history.
When you meet the doctor, you can determine if you feel comfortable communicating with him or her. Observe if the doctor does a comprehensive examination. Does he or she listen to you and explain what is being done and why? Does the doctor take time to answer your questions? Did the two of you establish an easy rapport?
When seeing a patient for the first time in a non-emergency situation, most doctors will begin a medical chart, compiling information about your health history. This record should include not only your present state of health and personal statistics (age, height, weight, occupation, whether you're a smoker or non-smoker), but also a family history– to help determine any possible hereditary health conditions that could develop.

We’re here to help
If you are a CCPOA Medial Plan member and would like assistance finding a Personal Physician, call your dedicated CCPOA Medical Plan Member Services team at (800) 257-6213. You can also talk or chat online with a registered nurse day or night, through Blue Shield of California’s NurseHelp 24/7sm. Call 1-866- 543-3728 or visit blueshieldca.com and click on Health & Wellness.