How we select providers and facilities
Every BridgeSpan network is designed so that it contains a variety of primary care providers, facilities and specialists within a specific geographic area. We choose providers and facilities to make sure that no matter what kind of care you need, you'll find a provider in your network who can offer it to you. Quality measures, member experience and cost-related measures are not used in our selection of providers or facilities.
Medical providers represent a broad range of specialties, such as medical doctors, oral surgeons, chiropractors, osteopaths, podiatrists and nurse practitioners. Behavioral health providers are included in the network, such as psychiatrists, addiction specialists and other types of behavioral health providers. Other types of providers are also included, such as hospitals, home health agencies, skilled nursing facilities and free-standing surgical centers.
If you have questions or need help, contact Member Services.
For information on available interpreter, communication, or language-assistance services, or accessibility information for a provider or a facility you would like to visit, contact us.
About the information in the Find a doctor tool
How and where do we get the information we provide in the Find a doctor tool? Find out.
Pre-authorization and referrals
You can use any of the benefits of this coverage without a referral.
Some medical procedures require pre-authorization before you receive treatment in order to get coverage from your health plan.
Pre-authorization allows us to review your treatment within the context of any other health issues you may have and to consider the latest scientific research available to manage your condition. Some conditions have a wide range of treatment choices, and some treatments work better than others. Checking in on your progress after a series of treatments helps us make sure your treatment is effective, medically necessary and right for you.
If a doctor does not get pre-authorization before treating you, your health plan will not cover those costs and the doctor may bill you for that treatment.
If you use an in-network doctor, you don't need to do anything. Our clinical partner evaluates your treatment plan to make sure it is the most effective treatment based on published research. Our partner also ensures that it is medically necessary and covered by your health plan.
If you use an out-of-network doctor, contact us about your options. Using an out-of-network doctor may mean higher out-of-pocket costs for you.
Some services that require pre-authorization
These treatments, services and equipment may require pre-authorization:
- Some surgeries and reconstructive surgery
- Planned admission into hospitals or skilled nursing facilities
- Transplant and donor services
- Specialized imaging such as MRIs, CT scans and cardiac imaging
- Non-emergency air ambulance transport
- Prosthetics and some orthotics
- Home medical equipment
- Interventional pain procedures
- Physical medicine services such as physical therapy and chiropractic care
- Sleep studies
These prescription medications may require pre-authorization:
- Some high-cost injectable medications
- Specialty drugs
How to find out if a procedure requires pre-authorization
For complete information about your plan's pre-authorization requirements, sign in and go to the Pre-authorization page or call the Member Services number listed on the back of your member ID card. Because some plans have different pre-authorization requirements, it's important for you to contact us if you have any questions about your coverage.