Since the end of 2013, many Californians have purchased health insurance plans from Anthem Blue Cross of California through the Covered California exchange program as outlined by the Affordable Care Act of 2010.
Unlike many insurance companies, doctors who are currently participating in various Blue Cross provider networks are not automatically participating in the Covered California networks.
While some doctors have decided to join the Covered California networks, others have opted not to due to decreased reimbursements or having no contract offered to them.
Whatever the reason, here are a couple quick and easy tips to determine if a patient’s plan is part of the Anthem Blue Cross Covered California network (Note: it’s not as simple looking for the Covered California logo on the card as most of them do not have it, nor will the card say “Covered California”).
If the ID card has one of the following, it’s a Covered California plan:
- The provider telephone number is (855) 634-3381.
- The ID number begins with alpha-prefix JQM, JQN, JQP, VXB, or VXD.
- The network has the word “Pathway” in it, ex. Pathway PPO.
Note to doctors: if you do not know whether you are participating in an Anthem Blue Cross Covered California network, you can search their website here.
Denise has owned and operated Medical Doctor Services since 1998.