You Can Find a Provider that Meets Your Needs
Blue Cross and Blue Shield of Georgia maintains strict guidelines to help ensure access to a quality network
It isn’t simply the number of doctors available that sets us apart from other healthcare insurers; it’s the quality of those doctors. You can feel confident that you are being treated by skilled and trained providers. Our Medical Management Department makes it an ongoing process to work with our Provider Contracting staff to maintain and recruit doctors with high levels of competence. Plus, if we ever see that a certain specialty of doctor is underrepresented in our network, we will seek out top doctors available to fill that gap.
Top doctors carry impressive credentials
Our Credentialing Committee (a panel of independent network doctors who are not Blue Cross and Blue Shield of Georgia employees) reviews all doctors’ qualifications prior to granting network participation. Adhering to strict standards, the committee will allow a provider to participate in our network after:
| Evaluating education, training and board certifications |
| Reviewing performance/work history (including any malpractice and disciplinary actions) and making sure the doctor has appropriate levels of malpractice insurance |
| Ensuring proper licenses are maintained (i.e., for practicing medicine in a specific area of expertise, for prescribing drugs, etc.) |
| Verifying that doctors have admitting privileges at local hospitals |
Member satisfaction is closely monitored
Complaints are thoroughly investigated and tracked to see if a pattern develops that might require action by our Credentialing Committee. In addition, doctors who are accepted into our network are reviewed every three years. We provide educational assistance to our network providers so that they can deliver optimal health services to you.
Our Clinical Practice Guidelines can assist doctors in providing appropriate care. Regular updates keep them aware of the latest medical advances, all to make sure you have access to the best possible care at all stages of your health.