To Avoid Charges Down the Road, You Need to Select and Use a Primary Care Physician

The PCP is your Primary Care Physician – the Blue Choice doctor you must use for all of your preventative and primary care. If your child uses a pediatrician and then needs to transition to a family doctor as a PCP, you must change your PCP information prior to the first doctor's visit. If you don’t do this, you may find yourself faced with unexpected charges!



If you go to your Employee Dashboard > Employee Online, you will find your PCP under Emergency and Physician Contacts. For your dependents, the PCP will be located in the blue column on the left hand side of the section, mid-way down select Step 1: Enter Your Emergency/Physician Contacts to view dependents PCP information.

You can go to Wellmark.com and use the “Find A Doctor tab” on the right hand side of their homepage. Select “Blue Choice” and then enter the other information needed and query the name of the doctor you want to switch to, double click on his/her name and then it should bring up his/her # (e.g., A3452). This is the # you need to enter on your Dashboard, along with his/her name and address. If the doctor’s name doesn't come up, then he/she is not a Blue Choice provider, and you cannot see him/her as an In-Network provider. However, keep in mind that although you may know the doctor as "Ted,” he might be listed as "Theodore," so you might have to try different name variations.



Next, go in to the Employee Dashboard and under the Employee Online tab, select Step 1: Enter Your Emergency/Physician Contacts (located in the blue column on the left hand side of the section, mid-way down). Select Add, which will bring up the screen in which you will correct the PCP information. Be sure to include the doctor’s city and hit Save.

And finally, call Wellmark at 800-524-9242 and provide them with your change information prior to visiting your new PCP, otherwise you could be responsible for 100% of your visit.

If you have any questions, contact Juliette Houseman, Benefits Specialist, at ext. 14315.