Picking a Primary
Care Provider (PCP)
I
f you are a new member and
need to pick a PCP, or if you
want to change your PCP, please
keep these things in mind:
Pick a PCP who is open. is
means the PCP is taking new
patients. You can see if a PCP
is open in the PCP section of
your Provider Directory. If you
are looking for a PCP from our
website, check the “Accepting new
patients” box in the online Provider
Directory. en the search will only
show PCPs who are taking new
patients.
Many PCPs are listed as
“Established patients only.” is
means they are not taking new
patients. ey will only accept
patients they have seen before,
usually in the last year. If you pick
a PCP in this category, we will have
to ask the PCP for approval. e
PCP will check the o ce records to
see if you are an established patient
and tell us yes or no. If you are not
an established patient, you will
need to pick an open PCP.
Some PCPs are open extended
hours. is means they may be
open some evenings and weekends.
e hours and days that PCPs are
open are listed in your Provider
Directory.
When you change your PCP, the
change is e ective the rst day of
the next month. For example, if you
call us September 18 to change
your PCP, the change is e ective
October 1. You may start seeing
your new PCP on or after October
1, not before then. You will get a
new Alliance ID card in the mail
the rst or second week in October,
with the name, address and phone
number of your new PCP on it.
In the meantime, you can use the
ID card you have. Your new PCP
can verify your eligibility and PCP
linkage with us online or by phone.
When you
need care now
GETTING IN TO SEE YOUR
PCP AS A NEW MEMBER
When you rst become an
Alliance member, you will pick
a Primary Care Provider (PCP).
If you don’t pick a PCP in your
rst month, we will assign you
to one.
Your PCP is the doctor you will
see whenever you need medical
care. If you need specialty care or
special tests, your PCP will refer
you.
Once you have a PCP,
it’s important to make an
appointment for a new patient
exam. You should call to make an
appointment right away. It can
sometimes take a few months to
get this type of appointment. At
this appointment, you and your
doctor will get to know each other.
Your PCP will ask you about your
medical history and your current
health conditions. Your PCP will
also ask you what medications
you are taking.
But what happens if you get
sick before you can see your PCP
for your new patient exam?
Call your PCP’s o ce. Let the
sta know that you are new to the
o ce but need to be seen right
away. Make sure to clearly explain
what you need to be seen for and
what your symptoms are. Your
PCP’s o ce will work with you to
make sure you get the care you
need.
3
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