Preferred providers are in our Blue Shield PPO network; non-preferred providers are not within our PPO network.
Under your PPO option, you save money and receive the highest level of benefits available when you go to a preferred provider.
To locate a preferred provider, including specialists, use Find a provider.
You can also call Member Services for a provider directory.
Choosing a Non-Preferred Provider
If you choose a provider that is not in our Blue Shield PPO network, you should be aware that Blue Shield has no contract with these providers for negotiated or allowed amounts. This means that you will be responsible for the difference between what Blue Shield allows for the service and what the provider charges.
Also, your copayments and deductibles may be higher, and your copayment maximum is often set at the highest level for your PPO option.
You'll need to pay the non-preferred provider directly for the entire cost of your care, and then you must file a claim with Blue Shield within one year of the month you receive these services.
If you have questions about filing a claim, visit Help with submitting a claim.
If you still have questions, please call the Member Services number on your Blue Shield ID card.