Know your designated providers
You’ll save money and get the highest
level of benefits. Ask your PCP today!
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Frequently asked questions:
What is a designated provider?
Designated providers, also called designated sites,
are providers your PCP has chosen to perform
certain health services.
When do I need to use a designated provider?
Visit designated providers for radiology (such as X-rays),
labs, and physical and occupational therapy. When you
need any of these services, you are required to use your
PCP’s designated site. You may also need to ask your
PCP for a referral or prescription.
How do I find my PCP’s designated providers?
The easiest way is to ask your PCP. You can also use the
Find a Doctor tool on ibxpress.com. Your designated lab
for blood work is indicated on your Independence Blue
Cross ID card.* Still not sure? Call the Customer Service
number on the back of your ID card.
Do I have to use designated providers?
If you do not use designated providers, your health
service may be considered out-of-network or not
covered at all, depending on your plan. For the
highest level of benefits, have your PCP refer you
to their designated providers.
What if I don’t like my PCP’s designated providers?
You may choose a new PCP if you don’t want to use
your PCP’s designated providers. Before you make your
selection, use the Find a Doctor tool on ibxpress.com to
search for PCPs in your area and to preview that PCP’s
designated sites.
Our Keystone Point-of-Service (KPOS) plan, for
example, lets you maintain freedom of choice by
allowing you to select your own doctors and hospitals.
You maximize your coverage by having care provided
or referred by your PCP. Of course, with KPOS, you
have the freedom to self-refer your care either to a
Keystone participating provider or to providers who do
not participate in our network; however, higher out-ofpocket
costs apply. This program may not cover all your
health care services.
Independence Blue Cross offers products through its subsidiaries Independence
Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance
Company, and with Highmark Blue Shield — independent licensees of the Blue
Cross and Blue Shield Association.
* On July 1, 2014, Independence Blue Cross ended its contract with Quest
Diagnostics®. This change may have had an impact on your PCP’s designated
provider for lab services. Most, but not all, PCPs use LabCorp as their designated
site. Please verify with your PCP or call the Customer Service number on the back
of your ID card with questions.
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