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Why do I need a primary care doctor (PCP)?

Having a relationship with a primary care doctor (PCP) can help keep your health on track. They’ll provide all your routine medical care (wellness checkups as well as sick visits). They also make referrals to specialists and other providers, help you get prior authorizations if needed, and schedule any lab work or medical tests you need. It’s easy to choose or change your PCP in your member account. Click here to find a provider in your plan's network. You’ll see pictures and ratings for many doctors, and you can also set online appointments with some of them.

Consider choosing a Value Choice Provider or a Total Care/Total Care Plus Provider (if available). They offer coordinated care and, for some services, a reduced cost for sick and wellness visits. Look for Value Choice Providers or Total Care/Total Care Plus under Programs in the online provider directory.

Be sure to give your doctor your most up-to-date email address and phone number, so you can get messages, lab results and directions for follow-up care.

How do I find a primary care doctor?

It’s easy to choose or change your PCP in your member account. Click here to find a provider in your plan's network. You’ll see pictures and ratings for many doctors, and you can also set online appointments with some of them.

Consider choosing a Value Choice Provider or a Total Care/Total Care Plus Provider (if available). These providers offer coordinated care and, for some services, a reduced cost for sick and wellness visits. Look for Value Choice Providers or Total Care/Total Care Plus under Programs in the online provider directory.

What’s a Value Choice Provider?

As a Florida Blue member, you may save time and money when you see a primary care doctor at any Sanitas Medical Center or Diagnostic Clinic Medical Group location. These Value Choice Providers offer you quality care — under one roof — for many conditions. And with more convenient hours, it’s easier to find time to go to the doctor.

You'll save time with on-site diagnostic tests at many locations, and you can request a Spanish-speaking doctor. They offer urgent care and same-day appointments on your schedule — most locations are open late and on weekends. And best of all, if you choose a doctor at Sanitas or Diagnostic Clinic Medical Group as your primary care doctor, you could have unlimited appointments for as low as $0 copay per visit. (This doesn't apply if you have a Health Savings Account plan.)

To find a location near you, visit www.mysanitas.com or www.dc-fl.com.

What is a Value-Based Provider and why should I choose one?

Value-based doctors put a special focus on helping you stay well. If you have a health condition, you can count on your doctor to make it simpler to get care and stay on a healthy track. This helps you save time, spend less and live your healthiest. When you’re sick, you’ll have a team to manage and guide your care.

Value Choice or Total Care/Total Care Plus providers are two types of primary care value-based doctors in the Florida Blue network. To find a value-based doctor near you, click here to get started.  

What’s the difference between a Value Choice Provider and a Value-Based Provider?

A value-based provider is a doctor in your network who puts a special focus on helping you stay well. They will work with you to create an ongoing wellness plan to guide your health care journey. And when you’re sick, they’ll work with a team to manage and guide your care. This can mean fewer unnecessary tests and services, lower costs and better care. Value-based providers offer same-day appointments, after-hours care and electronic communications. There are two types of primary care value-based providers in the Florida Blue network: Value Choice and Total Care/Total Care Plus providers.

Value Choice Providers is the name for a specific group of value-based providers. These doctors at Sanitas and Diagnostic Clinic Medical Group offer the same quality care that value-based providers do — with extra savings like unlimited $0 primary care doctor appointments where you can get X-rays, allergy testing and most allergy shots during that visit.

Doctors and hospitals with a status focus on health care instead of sick care. They go above and beyond for their patients by providing preventive services and wellness coaching. Plus, they help patients manage chronic conditions and coordinate specialized care, if needed. This can help you save time, spend less, and live your healthiest.

How do I change my primary care doctor?

You can pick a new PCP anytime in your online account or in the app. There you’ll be able to search for doctors in your area and submit your changes. Prefer to talk to someone? Stop by a Florida Blue Center or call the customer service number on the back of your member ID card.

Make sure to give your new doctor your email address and phone number, so you can get messages, lab results and directions for follow-up care.

Why did you change my primary care doctor?

If a doctor leaves your plan’s network, retires or moves away, we’ll send you a letter updating you. In most cases, we’ll go ahead and choose another doctor for you that’s close by. Make sure to give your new doctor your email address and phone number, so you can get messages, lab results and directions for follow-up care.

Just know that this selection isn’t set in stone! If you’d rather see someone else for care, you can log in to your account to find and select a different doctor or call us to let us know.

Why is my doctor not showing up in the online provider directory?

There are a lot of reasons why a doctor may not show up in the online provider directory:

  • They may not accept your plan option.
  • They may not be an in-network provider with Florida Blue.
  • Their information may be out of date.

If you’ve been seeing this doctor and haven’t made any changes to your coverage, the good news is that your doctor most likely is still in our network even though they aren’t showing up in the directory right now. You’ll still receive in-network benefits based on your health plan if you get care from an in-network provider who is not listed in the directory. 

The federal government requires health care providers to verify that their information is accurate and provide necessary updates each quarter. If they don’t verify their information, we’re required to remove them from the online provider directory until this is done. This means you’ll only see providers listed who are in our networks and whose information about them is accurate. It will make it easier to find care when you need it, plus save you money when you use an in-network doctor or other health care provider. 

Along with doctors and specialists, facilities also must verify their information each quarter, including but not limited to:

  • Hospitals 
  • Hospital outpatient departments
  • Ambulatory surgical centers 
  • Urgent Care Centers 
  • Hospital emergency rooms and freestanding ERs 

If you don’t see your doctor in our provider directory, contact the provider’s office to confirm they are still a participating provider for your health plan prior to your appointment. If you’re searching for providers in your area and aren’t finding one near you, call us at the number on the back of your member ID card and we can help. 

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