Plan ahead with in-network providers to help prevent surprise medical bills

Plan ahead with in-network providers to help prevent surprise medical bills

November 6, 2019

You have more power than you may think to keep your health care costs in check. The most important first step you can take is to always choose doctors, facilities and other health professionals who are in your plan’s network, starting with your primary care provider (PCP). Having a PCP you get to know and trust—and who gets to know you—will do more than help you save money. It will lead to better health care.

Reducing costs

You do have some control over your health care costs when it comes to planned medical visits, procedures and tests.

You should always take the following steps to help prevent surprise medical bills:

1. Choose providers in your health plan’s network. Prior to a planned medical procedure, talk to the provider who is performing your procedure. Ask your provider some questions, including the following:

  • Who will be performing your procedure and at which hospital/facility?
  • Will you have access to in-network providers at all stages of your procedure?
  • What are the names of all other health care providers who will be on your care team, such as radiologists, anesthesiologists, assistant surgeons and other facility-based providers?

2. Get a referral if you’re in HealthSelect of Texas®: Participants in the HealthSelect of Texas point-of-service plan need a PCP’s referral to most specialists. Without a referral on file, you will get out-of-network benefits – that means you’ll pay more, sometimes much more – even if the providers you see are in-network.

3. Check the network status of your care team. Verify through your health plan that all providers on your care team are in your health plan’s network. You can do a quick search for in-network physicians, providers and hospitals on your health plan’s website:

4. Find out estimated costs beforehand. You have the right to know the estimated cost of a medical procedure or test before it takes place. You can use the online tools of your health plan to help you compare providers based on price and quality:

  • As a HealthSelect of Texas participant, you can log into your Blue Access for Members account at https://healthselect.bcbstx.com and use the Cost Estimator tool, or call a Blue Cross and Blue Shield Personal Health Assistant toll-free at (800) 252-8039.
  • Scott and White Health Plan participants can log in and use the Provider Services Cost Estimator tool located under Customer Service.

Keep in mind: Facility-based providers, such as radiologists and anesthesiologists, often move from hospital to hospital, so it’s important for you to confirm the network status of your facility-based providers before each planned hospital procedure.