Blue Cross Referrals Are Easier Than you Think

by Barbara Griswold, LMFT (Aug 21, 2020)

Imagine this: You need to help a Blue Cross client with a referral. Maybe you don’t accept Blue Cross. Maybe your practice is full, or maybe the client needs a psychiatrist, a couples therapist, someone with a different specialty, or a therapist for her partner.

You may know there is an online provider directory; but you may not realize that you as a provider can use it to find Anthem or Blue Cross/Blue Shield providers anywhere in the country (this does not include Blue Shield of California, which is a separate company). I use it all the time to help clients with referrals. Better yet, I teach clients to use it.

Now here’s the key: The directory is confusing, and will trip up many clients. So give them the steps below so they can navigate, or use them yourself. You may want to cut and paste this info or bookmark this page. If you are like me you’ll share this info again and again. You might want to make a cheat sheet like this for the directories of the other plans you work for.

HOW TO LOCATE A BLUE CROSS PROVIDER:

To get a list of therapists on the plan, click here or go to https://www.anthem.com/find-care/

1) Before you do anything else, scroll to the top of the page, and make sure you adjust the state to reflect your state (it is in the gray bar under “Find a Doctor/Find Care;” click on “Select a State” or “Change State” if needed).

2) Now click on “guests,” unless you are a member and want to enter all your info.

3) Scroll down to answer the questions on the same page — when you are asked if you want medical or dental, answer “medical.”

4) When asked what kind of plan you want to search for, click on “Medical — Employer Sponsored” if you get your insurance through your employer, or you don’t know.

5) When asked to select a plan, if you don’t know, enter “Blue Cross PPO Prudent Buyer Large Group.”

6) On the following page, don’t enter anything in the space where it invites you to enter specialty or provider name or NPI. Do go ahead and enter a zip code, city or county on the right side of the search bar where you’d like to search. Then scroll down the page and click on “Behavioral Health Professionals.”

7) On the next page, names will be given. But this is everyone in that area you search for. Under the blue bar, you can click on the small box that says, “Areas of Expertise” to pare down the list, clicking the presenting issue the client is seeking treatment for.

8) If you want to narrow down your results and eliminate the names of doctors, go to one of the other small boxes under the blue bar, click on “Specialty,” and click on Marriage and Family Counselors, Licensed Clinical Social Workers, Licensed Professional Counselors, and Psychologists. You may have to go back several times to get these all checked, but it will pare down your results to just non-medical therapists. Don’t let the titles fool you — any of these counselors can provide individual therapy, if that is what is being sought.

You should now have a list of providers that take Anthem insurance that specialize in the area you are looking for. Remember, you will need to contact the provider to verify they are indeed a provider with that plan and that they are accepting new clients.