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Doctor & Hospital Finder

Provider Search FAQ

Make informed decisions about your healthcare. Learning more about providers can help you find the doctor, facility or other provider that's best for you. "Best" means different things to different people. Knowing more about providers and understanding how your benefits work can help you ask the right questions at the right time, so you get the most value out of your healthcare.

See what information is in a provider's profile, learn how your policy benefits affect the costs you pay for a provider's care and get search tips below.

Select a plan then you can type the name of a provider in the search box or browse for providers by location and/or specialty.

Please contact customer service for additional assistance. We may not have information about the provider you're searching for because they may not all be contracted to provide care under your Plan.

Use the link on the results page to generate a PDF of the directory you are searching. You can choose to email or download this PDF using the relevant buttons on the page

You can print by using the print command in your Internet browser or by using the ctrl+p command when using a PC or command+p when using a Mac. On several pages we provide a print button. Using this button will provide you with an optimized print page. When you print search results, you will only print the number of providers displayed in search results. To print additional results, you'll need to scroll further down the page to display more results and then use the print command.

Learning more about your providers can affect the care you receive. Where doctors practice, what languages they speak, where they were educated and a variety of other factors can impact your healthcare choices. Knowing which providers are covered by your insurance plan will also impact your out-of-pocket costs.

Profiles have information about providers* including:

  • Name
  • Name of medical group or clinic
  • If a provider works with a medical group, clinic or hospital, you can click through the link to the profile page for more information about the facility.
  • Practice/clinic locations
  • Many providers work at multiple places. We include the address, phone number (on-call phone number not included), map and directions to the different locations where a provider practices.
  • Credentials
    • The provider's specialty areas of practice are also included.
    • Board certifications show a provider's knowledge and skills in one or more areas of specialization. A licensed doctor must take an exam in front of a board of professional peers to become board certified.
    • Gender
    • Spoken language(s)
    • Lists languages spoken by provider and/or the office staff.
  • Appointment availability
    • Shows if the provider is accepting new patients at this time.
    • Office Hours
  • Quality
    • Includes accredited, independent, third party quality information such as certifications and awards from medical specialty board associations and medical board societies like The Joint Commission or the National Committee for Quality Assurance (NCQA).
    • Links To Hospital Compare data where it is appropriate.
  • Hospital affiliations
    • Show association between a provider and a facility which may include admitting privileges, employment or another form of affiliation. A provider may be affiliated with a hospital but not have admitting privileges.
  • Network affiliation(s)
    • By choosing your network we show only the providers and facilities that are available to you

We source quality data from independent third party sources that can be verified as more objective. These sources include the various recognition organizations like the National Committee for Quality Assurance (NCQA) or the Joint Commission or the Leapfrog group.

The provider, or his/her authorized representative, supplies the following:

  • Hospital Affiliations
  • Practice website URL
  • Contact email
  • Appointment availability
  • Office hours

We regularly refresh this data and work hard to ensure provider data is accurate. However, medical professionals sometimes change jobs or move to new locations. If you contact your provider and find information that is out of date, let us know by clicking the 'contact us' link.

We supply the following information about a provider which is updated weekly and validated for accuracy quarterly through a third party.

  • Education, specialties and board certification
  • Spoken language(s)
  • Practice locations and phone numbers (exception: on-call phone number)
  • Name of medical group provider is affiliated with if applicable.
  • Clinic locations
  • Member Reviews, including ratings and comments (participating providers only)
  • Network affiliation(s)
  • Gender

Typically these organizations bring together and summarize their quality data from multiple sources and are themselves responsible for its accuracy. As an example, quality recognitions identify doctors and/or hospitals who have met a variety of performance improvement activities, including participation in clinical improvement programs for doctors and hospitals, completion of educational modules and maintenance of board certifications for doctors and accreditation for hospitals.

Facility quality designations mean these facilities' overall experience and aggregate data met objective criteria established in collaboration with expert clinicians' and leading medical societies' recommendations. Individual outcomes may vary. Because we are not compiling these designations directly, we are not responsible for any damages, losses, or non-covered charges that may result from using these materials or receiving care from any provider.

If you have questions or concerns about a provider's profile information, please contact customer service.

If you have questions or concerns about a provider's profile information, please contact customer service.

If you have questions or concerns about a provider's profile information, please contact customer service.

When you search our site we will always ask for your current plan before allowing you to search. The search results will show only provider's associated with the network and corresponding health plan products tied to those networks. You may also contact customer service for more information about network participation. Provider network information is updated on a regular basis.

Print-A-Directory helps you make smarter choices by giving you several ways to refine and sort your results. You can see providers nearest to you, coverage levels for each provider, patient reviews and quality reports for providers.

No. Print-A-Directory is for informational purposes only. The information here or on any linked sites is not a substitute for medical advice. It may be helpful to use this information combined with other research in discussions with healthcare professionals to make care decisions that offer the best possible results and lowest costs.

Your benefits coverage and your costs will vary depending on the provider you choose and the discount negotiated with the provider networks in your plan. Many clinics have affiliated doctors and healthcare providers whose networks and discount rates differ from the clinic's rates. Be sure to double-check your benefits before you visit providers.

We display networks and corresponding health plan products as part of the provider listings. If you choose to receive services from a provider whose networks are not tied to your health plan product, you may receive no benefit or a reduced benefit, subjecting you to higher out-of-pocket costs. Be sure to review your benefits for more information.

Please contact customer service for more information about your benefits.

You can quickly find the right provider for your needs by sorting your results columns, refining your results and learning more about providers' network participation. You can sort your results by clicking the column header at the top of the search results table.

You can narrow your results by using the "Additional Search" option on the main search page. Choose from options including:

  • Availability
  • ER Alternatives
  • Networks
  • Quality Reports
  • Specialties
  • Gender

You cannot search without picking a network plan. Once you have picked a network plan enter your search terms into the search bar.

Third party quality reports and quality recognitions help you make informed decisions about your healthcare. Preventive care and screening are an important part of creating healthy habits and preventing illness and disease. You can see what preventive screenings are offered by a provider, view provider ratings and learn how many patients were treated according to Healthcare Effectiveness Data and Information Set (HEDIS®) guidelines in the Quality Reports area. You can also view the percentage of patients treated according to HEDIS guidelines by all local providers to compare a provider with others in the area.

The details used in Quality Reports are based on Healthcare Effectiveness Data and Information Set (HEDIS) measures from the past 12-24 months. HEDIS is used by more than 90% of America's health plans to measure provider performance on important phases of care and service. Preventive care includes screenings and/or treatments for asthma, back pain, cancer, depression, diabetes, heart disease, immunizations, respiratory infections as well as medication monitoring and healthcare screenings for women.

Quality Reports include information about:

  • The overall rating given to the provider (below average, average or above average), based on the combined provider rating
  • Preventive care and screening options available from the provider
  • The average rating for the provider
  • Quality Reports based on HEDIS measures include:
  • The number of patients treated
  • The percentage of patients treated
  • The percentage of patients treated by other providers in the surrounding area (the local average)

Process of care ratings show how often patients with specific medical conditions and patients having surgical procedures receive recommended care from hospitals, clinics and other facilities. This information is collected from patient records and can help you compare provider quality of care.

The Centers for Medicare & Medicaid Services developed a standardized set of steps hospitals should take in order to ensure better treatment outcomes. Hospital protocols were developed for treating heart attack, heart failure or pneumonia as well as preventing infections related to surgical procedures. Information about how often providers provide recommended care is compiled from patient records and displayed as process of care ratings in the Quality Reports area.

Quality recognitions provide you with information about providers' accomplishments and special training to help you determine how a provider compares to other providers. Quality recognitions include awards, certifications and related qualifications granted to providers by accredited independent third parties. The Blue Physician Recognitionâ„  program recognizes both primary care physicians and specialists who have demonstrated a commitment to delivering quality and patient-centered care through participation in accepted national, regional, and/or local quality improvement or recognition programs.