Blue cross blue sheild of texas - Acceso a la cuenta | Blue Cross and Blue Shield of Texas. Pregunte. Solicite un folleto. Solicite un agente. Llámenos. Envíenos su pregunta para que un agente de seguros con licencia pueda comunicarse con usted. Nombre*. Apellido*. Teléfono*.

 
Jun 14, 2021 · Our customer satisfaction ratings are consistently above 96 percent. Focus on the member's needs, not just the question, and consider it their job to answer the "unasked" questions that may ultimately provide better assistance for the member. Have a solid track record of achieving first call resolution of members' needs more than 90 percent of ... . Captions ai

Blue Cross Blue Shield of Texas. Español. A simple, secure way to manage your care. Review your claims any time, anywhere. ... Blue Access for Members SM is a secure portal. You can find out about your health plan benefits, review your claims, and much more. You will need your ID card to sign up.Insurance products issued by Dearborn Life Insurance Company, 701 E. 22nd St. Suite 300, Lombard, IL 60148. Blue Cross and Blue Shield of Texas (BCBSTX) is the trade name of Dearborn Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association.Blue Cross and Blue Shield of Texas c/o 1095-B Form Request PO Box 660044 Dallas, TX 75266-0044 Once this form is received, your Form 1095-B will be mailed to your address on file within 30 days. Email Fill out the 1095-B Request Form, then attach the completed form to an email message. Please send this email 4 to [email protected]. Once ... BCBSTX vision plans have large provider networks. Based on your location, you may be able to get in-network care at: LensCrafters ®. Pearle Vision. Sears ® Optical. Target Optical ®. Note: If you get coverage through your job, ask your employer’s HR department if vision insurance plans are offered. 1 Coverage Plus Central provides ... The Personal Health Manager provides you with online information, resources, and tools to help you maintain your healthplan. You can use it to: Learn more about the Personal Health Manager. Login to the Personal Health Manager through Blue Access® for Members. See how BlueEdge fits your budget by using the HealthPlan Cost Estimator Tool. All Blue Cross and Blue Shield of Texas Silver plans offer the same set of health benefits, quality and amount of care. Your Silver plan options are different in how much you’ll pay each month, how much of your health care bill is covered for things like hospital visits and prescriptions and how much your out-of-pocket costs are: Silver plans have a monthly bill …Tell us what you’d like to do. Find a Doctor, Lab, or Hospital. Choose a Primary Care Provider (PCP) Find Benefit Details. Schedule a Virtual Visit. Earn Rewards with …You can choose or change your PCP by calling a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY: 711) or by logging in to Blue Access for Members SM: Log in to Blue Access for Members. Click on the "Find Care" tab. On the Find Care page, see your current PCP on the right-hand side for each covered family member, if you already ...Forms and Helpful Resources. If you are already a member of the Blue Cross and Blue Shield of Texas (BCBSTX) family, discover all the ways you can take advantage of the special features that come with your health insurance plan. Register today for …COVID-19 PHE Ends. We’re here to keep you informed about how the end of the COVID-19 public health emergency affects your benefit coverage. The Biden Administration ended the COVID-19 public health emergency on May 11, 2023. Some of your COVID-19 benefits have changed with the end of the public health emergency. Vaccines. Tests and Testing …A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 757631.1021 Your Digital ID Card and More Access the Secure Member Site Go to bcbstx.com and click the Log In tab to register for Blue Access for MembersSM. Click the Register Now link andAn HCA is an employer-funded spending account that engages and empowers employees – they decide how their health care dollars are spent. Charges for covered medical care services are first paid from this account. Money spent from the HCA is also applied toward the annual deductible. Unspent funds roll over from year to year.When comparing Blue Cross and Blue Shield of Texas options, you might come across a few different plan types: HMO: A Health Maintenance Organization keeps costs low by working with your primary care doctor for any needs and specialty referrals. PPO: A Preferred Provider Organization lets you choose where you go for care without needing ...Blue Cross Blue Shield Association. / 41.8864516; -87.6239771. Blue Cross Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States -based federation with 34 independent and locally-operated BCBSA companies that provide health insurance in the United States to more than 115 million people as of 2022.The following plans are available to you as a State of Texas agency or institution employee or non-Medicare-eligible retiree. Throughout this exercise, we will ask you simple questions to help guide you to make the best decision for your health care benefits. ... a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue ...Blue Cross and Blue Shield of Texas Attn: Enterprise Credentialing P.O. Box 65067 Dallas, TX 75265-0267; Hospital Privileges Requirements. The requirements for hospital/clinical admitting privileges are determined by the professional provider's specialty/provider type. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Outside the United States. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. Compare and apply for health insurance plans in Texas, including individual and family, Medicare, short term and HSA compatible plans. Find a doctor, learn about benefits and …If you are in a crisis situation and need immediate help finding resources for care, call 1-800-252-8039 (TTY: 711) and ask to speak to a mental health clinician. BCBSTX Personal Health Assistants can help with changing appointments, finding a new provider or answering benefit questions.An HCA is an employer-funded spending account that engages and empowers employees – they decide how their health care dollars are spent. Charges for covered medical care services are first paid from this account. Money spent from the HCA is also applied toward the annual deductible. Unspent funds roll over from year to year.Blue Cross Medicare Advantage plans offer all-in-one options that provide medical and prescription drug coverage. Combine what’s covered by Part A and Part B, with added benefits. They Provide: Medicare Part A (hospital insurance) coverage. Medicare Part B (medical insurance) coverage. Limits on your out-of-pocket costs. The Personal Health Manager provides you with online information, resources, and tools to help you maintain your healthplan. You can use it to: Learn more about the Personal Health Manager. Login to the Personal Health Manager through Blue Access® for Members. See how BlueEdge fits your budget by using the HealthPlan Cost Estimator Tool. Blue Cross and Blue Shield of Texas 4444 Corona, Suite 148 Corpus Christi, TX 78411-4375 1-361-878-1623 Fax: 361-852-0624 Email to submit provider inquiries and questions. Dallas and East Texas. See "North Texas" El Paso. Blue Cross and Blue Shield of Texas 114 Mesa Park Dr. Suite #300 El Paso, TX 79912 -6156 1-915-496-6600, press 2 Fax: 915 ... The BlueCard Program* helps Blue Cross and Blue Shield of Texas (BCBSTX) members: Get needed health care when you travel or live outside your Blue Plan service area. Get the same benefits as your BCBSTX plan when you travel or are away from home for an extended amount of time. Find a doctor or hospital throughout the United States — More …An HCA is an employer-funded spending account that engages and empowers employees – they decide how their health care dollars are spent. Charges for covered medical care services are first paid from this account. Money spent from the HCA is also applied toward the annual deductible. Unspent funds roll over from year to year.Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Page 1 of 6 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan wouldIf you're age 26 and losing coverage under a parent's plan, compare BCBSTX plans and find the right one for you. 1 Up to age 26 unless medically disabled. When you turn 26, it's considered a qualifying event. You must buy your own insurance now. Educate yourself on what you need in a health care plan and more at BCBSTX.Your doctor can order a COVID-19 diagnostic test and coordinate your testing at an in-network lab or pharmacy. If you don’t have a primary care doctor, we can help you find one. Call us at the Customer Service number on your BCBSTX member ID card. You can also find an in-network doctor by logging in to Blue Access for Members SM or ...A PPO plan lets you choose your doctors and providers without a referral, but with higher costs. Learn how to use your PPO network, get pre-authorization, and find in-network …BCBSTX Mobile App. Features: Find an in-network doctor, hospital or urgent care facility or search for Spanish-speaking doctors. Access your claims, coverage and deductible information. Access your temporary digital member ID card. Secure login with Face ID (iOS only) and Fingerprint ID. Payments on the Blue Access for Members Mobile App are here.The drug lists below are used with BCBSTX "metallic" health plans that are offered through your employer. These can include Platinum, Gold, Silver, or Bronze plans. If your company has 1–50 employees, your prescription drug benefits through BCBSTX are based on a Drug List, which is a list of drugs considered to be safe and effective. If you are a …To check your eligibility and to learn more about Virtual Visits benefits, visit MDLIVE or call 1-866-954-3585. MDLIVE® is a separate company that has contracted with Blue Cross and Blue Shield of Texas (BCBSTX) to provide virtual visit services for members with coverage through BCBSTX. MDLIVE is solely responsible for its operations and for ... Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue ... To check your eligibility and to learn more about Virtual Visits benefits, visit MDLIVE or call 1-866-954-3585. MDLIVE® is a separate company that has contracted with Blue Cross and Blue Shield of Texas (BCBSTX) to provide virtual visit services for members with coverage through BCBSTX. MDLIVE is solely responsible for its operations and for ...An HCA is an employer-funded spending account that engages and empowers employees – they decide how their health care dollars are spent. Charges for covered medical care services are first paid from this account. Money spent from the HCA is also applied toward the annual deductible. Unspent funds roll over from year to year.Texas STAR, CHIP — 1-877-560-8055. STAR Kids — 1-877-784-6802. For out-of-state Blue Cross and Blue Shield members, call BlueCard® Eligibility at 1-800-676-BLUE (2583) for eligibility and benefit verifications. Learn more about BlueCard. For Federal Employee Program (FEP) members, eligibility and benefits can be obtained by calling 1 …Blue Cross and Blue Shield of Texas. P.O. Box 660044. Dallas, Texas 75266-0044. To report waste, abuse or fraud, gather as much information as possible. You can report waste, abuse or fraud to BCBSTX's Special Investigations Hotline 24 hours a day, seven days a week toll-free at 1-800-543-0867. The hotline is confidential and anonymous.Access Your Benefits. You can use our interactive search to find your local Blue Cross Blue Shield Company's website. Your local company can help you to: Change your coverage. Estimate the cost of a medical procedure. File or check on claim. Replace your member ID card. Review your balance. View your plan details.Blue Access for Members SM is a powerful tool for managing your Blue Cross and Blue Shield of Texas health plan benefits. You can opt in to receive your mail digitally, find a doctor and review your coverage.An HCA is an employer-funded spending account that engages and empowers employees – Employees decide how their health care dollars are spent. Charges for covered medical care services are paid from this account. Money spent from the HCA is also applied toward the annual deductible. Unspent funds roll over from year to year.Blue Cross and Blue Shield of Texas 1001 E. Lookout Drive Richardson, Texas 75082 General Information: (972) 766-6900 TDD: (800) 735-2989 (for the hearing-impaired) Customer Service Numbers; Group Products: For Customer Service please call the number on the back of your ID card, or call one of the following numbers: If you no longer qualify for Medicaid, we can help you find the right health coverage. Anthem Individual and Family plans can be an affordable option for you and your family. Talk to a health plan consultant: 833-828-6962 (TTY: 711) Mon-Fri, 8 am to 8 p.m. ET, 8 a.m. to 7 p.m. CT, 7 a.m. to 6 p.m. MT, 7 a.m. to 5 p.m. PT. Compare and apply for Texas health insurance plans online at BCBSTX. Find individual and family, Medicare, short-term and HSA compatible plans and rates. Blue Cross Blue Shield of Texas - Health Insurance Texas. Get a free instant rate quote and apply online today for Texas health insurance plans including individual and family health insurance, Medicare supplement, short term health insurance and health savings account (HSA) compatible plans at www.bcbstx.com. Prior Authorization Requests for Medical Care and Medications. Some medical services and medications may need a prior authorization (PA), sometimes called a “pre-authorization,” before care or medication can be covered as a benefit. Ask your provider to go to Prior Authorization Requests to get forms and information on services that may ...When comparing Blue Cross and Blue Shield of Texas options, you might come across a few different plan types: HMO: A Health Maintenance Organization keeps costs low by working with your primary care doctor for any needs and specialty referrals. PPO: A Preferred Provider Organization lets you choose where you go for care without needing ... Compare and apply for Texas health insurance plans online at BCBSTX. Find individual and family, Medicare, short-term and HSA compatible plans and rates. Buy health insurance from BCBSTX. We offer individual, family and Medicare supplement plans for your health care needs, so get your free quote today! Blue Cross and Blue Shield of Texas will guide you in the right direction. Enroll today. Call: 1-855-453-5945 * First Name Please enter a First Name Find a Doctor. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: Select Blue Cross Blue Shield Global™ or GeoBlue if you have international … Blue Cross and Blue Shield of Texas will guide you in the right direction. Enroll today. Call: 1-855-453-5945 * First Name Please enter a First Name I want to nominate a provider who is not already in the HealthSelect network: There currently are more than 133,000 providers in the HealthSelect SM network across the State of Texas, with providers being added on a regular basis. If your current provider is not listed in the HealthSelect network, you can nominate her/him using this form.A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 757631.1021 Your Digital ID Card and More Access the Secure Member Site Go to bcbstx.com and click the Log In tab to register for Blue Access for MembersSM. Click the Register Now link andWhen you need to find a doctor or hospital, take the time to research your options. Follow the steps below to help find a provider or medical facility that meets your needs. 1. …Get a Quote/Browse and Buy Plans. Premium Tax Credit Estimator. Individual & Family Plans. Medicare Plans. Log in to Blue Access for Members. Register for Blue Access …Dental Insurance. Under the Affordable Care Act (ACA), dental coverage is free for children 18 and younger and optional for all adults. These dental plans are offered by the government when you enroll during Open Enrollment or with a qualifying life event. You can also enroll with BCBSTX if you need dental coverage in addition to your current plan. Forms and Helpful Resources. If you are already a member of the Blue Cross and Blue Shield of Texas (BCBSTX) family, discover all the ways you can take advantage of the special features that come with your health insurance plan. Register today for Blue Access for Members. Blue Cross and Blue Shield of Texas Medical Drug Benefit List. This list is subject to change without notification. Legend: $ = under $100, $$ = $100-$250, $$$ = $251-$500, $$$$ = $501-$1,000, $$$$$ = over $1,000, A = drug not subject to medical deductible or member cost share, * = drug may require prior authorization inYour doctor can order a COVID-19 diagnostic test and coordinate your testing at an in-network lab or pharmacy. If you don’t have a primary care doctor, we can help you find one. Call us at the Customer Service number on your BCBSTX member ID card. You can also find an in-network doctor by logging in to Blue Access for Members SM or ...The Medical Record Status Viewer is an online application that allows providers to confirm receipt (up to four) of the most recent medical records submitted by mail or fax to Blue Cross and Blue Shield of Texas (BCBSTX) for claim processing and prior authorization requests.. Steps to confirm medical record receipt status online: Log into Availity EssentialsTexas STAR, CHIP — 1-877-560-8055. STAR Kids — 1-877-784-6802. For out-of-state Blue Cross and Blue Shield members, call BlueCard® Eligibility at 1-800-676-BLUE (2583) for eligibility and benefit verifications. Learn more about BlueCard. For Federal Employee Program (FEP) members, eligibility and benefits can be obtained by calling 1 … Forms and Helpful Resources. If you are already a member of the Blue Cross and Blue Shield of Texas (BCBSTX) family, discover all the ways you can take advantage of the special features that come with your health insurance plan. Register today for Blue Access for Members. Find affordable health plans for individuals, families, Medicare and Medicaid recipients in Texas. Learn about COVID-19 coverage, online community, careers and corporate …Prior Authorization Requests for Medical Care and Medications. Some medical services and medications may need a prior authorization (PA), sometimes called a “pre-authorization,” before care or medication can be covered as a benefit. Ask your provider to go to Prior Authorization Requests to get forms and information on services that may ...To Complete Form go to Page 4. Use this form to authorize Blue Cross and Blue Shield of Texas (BCBSTX) to disclose your protected health information (PHI) to a specific person or entity. You may follow the instructions below or call the number listed on your Member ID card if you need help completing the form. You must complete the entire form. Company Information. Blue Cross and Blue Shield of Texas, a division of Health Care Service Corporation, a Mutual Legal Reserve Company, an independent licensee of the Blue Cross and Blue Shield Association. For more than 90 years, we have forged alliances with local nonprofit organizations to show our commitment to help build healthy communities. Blue Cross and Blue Shield of Texas (BCBSTX) has been serving individuals and families in Texas for 90 years. In collaboration with Sanitas Medical Centers, we are working together to bring you an easier way to access health care. At Sanitas Locations, BCBSTX Members Can Expect: One-on-one assistance to help you choose your health …Blue Cross and Blue Shield of Texas (BCBSTX) Contact Information: For EVV questions, call Provider Customer Service at 1-877-784-6802 or email the EVV Mailbox at [email protected]. For Service Coordination needs, call 1-877-301-4394 (TTY 7-1-1) Information on how to submit a Complaint or Appeal.CareFirst BlueCross BlueShield. Remote in Baltimore, MD 21224. $61,560 - $122,265 a year. Full-time. Easily apply. This role will serve as the face of our CareFirst BlueCross BlueShield government programs including Medicaid and Medicare in Eastern Maryland. Posted 30+ days ago ·. More...Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.Blue Cross and Blue Shield of Texas (BCBSTX) offers Individual health plans for yourself and your family, Medicare plans and Medicaid plans for those who qualify. Individual & Family Plans. Need 2021 coverage? You can apply for … Sales Questions and Additional Plan Information: 1-888-731-0406. Calls may or may not be answered inside the United States. Monday – Friday: 8 a.m. – 8 p.m. CT Access Your Benefits. You can use our interactive search to find your local Blue Cross Blue Shield Company's website. Your local company can help you to: Change your coverage. Estimate the cost of a medical procedure. File or check on claim. Replace your member ID card. Review your balance. View your plan details.Durable Medical Equipment Reimbursement Schedules / Prosthetics & Orthotics Reimbursement Schedules. 2024 Schedules effective 2/1/24. 2020 Schedules effective 3/1/20 - 1/31/24. 2017 Schedules effective 10/1/17 – 2/29/20. 2015 Schedules effective 11/1/15 – 9/30/17. 2014 Schedules effective 7/1/14 – 10/31/15. 2013 Schedules …The Medical Record Status Viewer is an online application that allows providers to confirm receipt (up to four) of the most recent medical records submitted by mail or fax to Blue Cross and Blue Shield of Texas (BCBSTX) for claim processing and prior authorization requests.. Steps to confirm medical record receipt status online: Log into Availity EssentialsSearch for doctors, hospitals, pharmacies, urgent care and more in your plan network. Log in as a member to get personalized results, reviews, ratings and cost estimates, or … Follow the prompts to join the Fitness Program. Or you can call the Fitness Program toll-free at (888) 762-BLUE (2583), Monday through Friday, 7 a.m. – 7 p.m. CT. Membership can be cancelled at any time by calling the Fitness Program toll-free at (888) 762-BLUE (2583). Earn 2,500 Blue Points for joining the Fitness Program and up to 300 ... Blue Cross and Blue Shield of Texas 1001 E. Lookout Drive Richardson, TX 75082-4144. FEP Service 4002 Loop 322 Abilene, TX 79602. www.bcbstx.com . Claims/Customer Service. Blue Cross and Blue Shield of Texas P.O. Box 660044. Dallas, TX 75266-0044. Customer Service. 1-800-442-4607. Precertification.Blue Cross Blue Shield of Texas Claims Overpayments Dept. CH 14212 Palatine, IL 60055-4212; Courier Address: Blue Cross Blue Shield of Texas Claims Overpayments Box 14212 5505 North Cumberland Ave., Ste. 307 Chicago, IL 60656-1471; Claims Status Inquiries. Payer ID – HCSVC; Appeals.

BCBSTX Mobile App. Features: Find a doctor, hospital or urgent care facility. Access your claims, coverage and deductible information. Ability to view and email your ID. Available in Spanish. Available for iPhone and Android users. To download the app, text* BCBSTXAPP to 33633 or search for BCBSTX in the Apple App Store or Google Play .. Ord to icn

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Blue Cross Blue Shield of Texas | 3,444 followers on LinkedIn. Blue Cross Blue Shield of Texas These tools and services can help you use your Blue Cross and Blue Shield of Texas (BCBSTX) membership. Log in to Blue Access for Members SM (BAM SM) Log in to your account to access your health plan information: Find an in-network doctor, hospital or other provider; Pay your bill; Review benefits, account balances, claims status and more BCBSTX vision plans have large provider networks. Based on your location, you may be able to get in-network care at: LensCrafters ®. Pearle Vision. Sears ® Optical. Target Optical ®. Note: If you get coverage through your job, ask your employer’s HR department if vision insurance plans are offered. 1 Coverage Plus Central provides ... Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Life, Accidental Death & Dismemberment and Disability insurance is underwritten by Dearborn Life Insurance Company, 701 E. 22nd St. Suite 300, Lombard, …Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield AssociationThe Health Assessment takes about 15 minutes and asks a series of questions about your lifestyle and health habits. It will provide an overall assessment of your current health, including how your health compares to others in your age group. It will identify what you are already doing well and where there are opportunities for improvement.Find a Doctor. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: Select Blue Cross Blue Shield Global™ or GeoBlue if you have international … Blue Cross and Blue Shield of Texas 4444 Corona, Suite 148 Corpus Christi, TX 78411-4375 1-361-878-1623 Fax: 361-852-0624 Email to submit provider inquiries and questions. Dallas and East Texas. See "North Texas" El Paso. Blue Cross and Blue Shield of Texas 114 Mesa Park Dr. Suite #300 El Paso, TX 79912 -6156 1-915-496-6600, press 2 Fax: 915 ... About Us. Blue Cross and Blue Shield of Texas is a statewide, customer-owned health insurer. We believe Texas consumers and employers deserve the best of both worlds: access to affordable, quality health care and top-notch service from a company that focuses solely on customers, not shareholders. Customer value is our cornerstone. Blue Cross and Blue Shield of Texas (BCBSTX) has been serving individuals and families in Texas for 90 years. In collaboration with Sanitas Medical Centers, we are working together to bring you an easier way to access health care. At Sanitas Locations, BCBSTX Members Can Expect: One-on-one assistance to help you choose your health …The following plans are available to you as a State of Texas agency or institution employee or non-Medicare-eligible retiree. Throughout this exercise, we will ask you simple questions to help guide you to make the best decision for your health care benefits. ... a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue ...Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Life, Accidental Death & Dismemberment and Disability insurance is underwritten by Dearborn Life Insurance Company, 701 E. 22nd St. Suite 300, Lombard, …When comparing Blue Cross and Blue Shield of Texas options, you might come across a few different plan types: HMO: A Health Maintenance Organization keeps costs low by working with your primary care doctor for any needs and specialty referrals. PPO: A Preferred Provider Organization lets you choose where you go for care without needing ...Get the latest from FEP. Be the first to know about our benefits, wellness incentives and rewards you're eligible for with your plan. Learn all about the #1 health insurance choice for federal employees, retirees and their families.PCP and Referral Requirements. Some Blue Cross and Blue Shield of Texas (BCBSTX) plans require the member to select a Primary Care Provider (PCP) who is responsible for referring the member for services to most specialty care providers and facilities. It is essential the PCP refer members, requiring such care, to participating physicians or ....

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