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Using Blue Cross network providers can reduce costs

Knowing the difference between in-network providers and out-of-network providers could save you a lot of green.

First, what is a provider?

A provider is a professional who provides healthcare services. Providers can be doctors, dentists, physical therapists, chiropractors or psychologists. Blue Cross arranges contracts with a wide range of providers in a wide range of specialties.

The group of providers is what we call our network. When you see one of these in-network providers, you can be assured that you are only responsible for your copayment, deductible and/or coinsurance for covered services.

With providers who are not in our network, however, you could be responsible for much more – as much as hundreds or thousands of dollars.

It's simple to find an in-network provider by using the Blue Cross online provider directory.

Everyday example:

When Cliff needed knee surgery, he chose a doctor from Blue Cross Idaho's extensive network. Because Cliff chose an in-network provider, Blue Cross of Idaho covered much more of the bill. Cliff paid thousands of dollars less than he would with an out-of-network provider.

Be careful not to accidentally go out of network.

For instance, your doctor may refer you to a specialist without knowing whether or not that specialist is in the network. Don't assume that your doctor knows the details of your coverage.

Instead, ask the office staff to contact the specialist to confirm whether he or she is not out-of-network. If needed, ask the doctor for another specialist. You may also check the status of a provider searching our provider directory.