All available provider information is validated, at a minimum, every three years through credentialing process.
Information provided directly by provider.
- Provider or Group name – all or part of the doctor’s name or practice’s name
.
- Facility Name – all or part of the hospital’s name.
- Gender – M=male; F=female.
- Medical group affiliations, if applicable – an organization that a group of doctors/practitioners are directed by.
- Languages – all languages spoken by provider/clinical staff are listed.
- Accepting new patients – if provider is currently accepting new patients (applies to general and internal medicine, family practice, pediatrics, obstetrics/gynecology and high volume behavioral health.
Information provided directly by provider but validated through industry standard sources.
- Specialty category – General category of specialty, eg., Pediatrics.
- Specialty – individual specialties within the general specialty category, eg., Pediatric Cardiology (specialty includes all that are applicable, subspecialty is optional).
- Network – your health benefit plan’s provider network.
- Zip Code – identifies the location of the provider practice.
- Board certification with expiration date – A physician’s advanced credentials indicating a high degree of competence and training in their area of specialty.
- Accreditation – voluntary process to be surveyed against industry standards for comparative purposes.
- Hospital Affiliations – admitting/attending privileges at listed hospitals.
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Real Time Icon - Providers who display a
icon have the capability to receive a claim estimate and also submit claims--in real time--before you leave the office. This allows providers to estimate your responsibility at the point of service, reducing confusion and administrative hassles.
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Blue Distinction ® recognizes medical facilities that have demonstrated expertise in delivering quality healthcare to our members, based on objective selection criteria. We currently offer Blue Distinction Centers for Bariatric Surgery, Cardiac Care, Complex and Rare Cancers, and Transplants. Click the icon
for more information
.