Choosing A Provider
Preferred Choices PPO is committed to ensuring that our members
receive quality health care services. As part of our commitment,
we also want to provide our members with information to help them
make informed decisions about their health care. The articles linked
below will help you to review key professional qualities when selecting
a participating physician.
Selecting A Personal Physician
Verifying Provider Credentials
Questions to Ask About A Provider
Additional Links
Selecting a Personal Physician
The provider directory contains the names, addresses and phone
numbers for each participating physician, including personal physicians
(such as family practitioners, internists, pediatricians), specialists,
hospitals and other health care professionals.
Reviewing Important Quality Information
Because the best medical care depends on strong physician-patient
relations, we encourage you to take an active role in reviewing
important quality information before selecting your personal physician.
Information available through Preferred Choices PPO can help you
determine critical background information on physicians to ensure
your chosen physician meets your care expectations.
When selecting a personal physician, we encourage you to verify
information such as:
- Physician's board-certification status:
Is the physician certified by a review board to practice in his or her area
of specialty?
- Physician's hospital affiliation:
Does the physician practice in a hospital that meets your quality expectations?
- Professional education:
Where did the physician receive his or her education?
- Practice duration:
How long has the physician been in a medical practice?
- Method of physician compensation:
How is the physician paid for his or her services?
- Other consumer satisfaction measures:
Does the plan have any consumer satisfaction data for the physician? What
do your friends or family know about the physician?
- Other quality measures important to you and your family:
Including language, gender or age.
Our website also includes the following information:
- Provider type
- Specialty
- Hospital affiliations
- Board-certification
- Whether the physician is accepting new patients
For additional information, such as the physician's age, gender,
ethnicity, location, degree, board-certification eligibility status
and verification of other quality-related physician information,
please call Customer Service at 1-800-992-6837.
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Verifying provider credentials is an important
process
Why this information is important for you to know
Checking the background data on health care providers will help
you validate whether the provider fits your personal needs and
has met certain quality standards.
Preferred Choices PPO has already done a great deal of work to
help you by setting specific standards that all physicians must
meet to participate in our provider network. When we verify a physician's
credentials, we:
- Verify whether the physician has a current, active license
in Michigan to practice medicine.
- Learn where the physician went to medical school and received
training.
- Learn whether the physician did a residency, the residency
specialty and where the residency occurred.
- Learn what hospitals the physician is affiliated with.
- Learn where the physician worked previously.
- Learn the physician's last five-year malpractice history.
- Learn how many patients the physician treats.
Certified or eligible?
You may also wish to ask questions about the following credentials
when you select a primary care physician or when you are referred
to a specialist.
Board certification means that a physician completed several
years of specialty medical training (residency and/or fellowship)
and passed exams in that field. Exams are designed to ensure that
physicians have the knowledge, experience and skill required to
provide quality care in a particular medical or surgical specialty.
Board eligible means that a physician passed the written
exam but did not take the oral exam. In most cases, "board
eligible" reflects knowledge and experience in a particular
specialty medical or surgical field.
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Questions You Can Ask About A Provider
You can use the following steps to verify the professional credentials
of your personal physician or specialist:
- Search the provider directory.
Our provider directory lists all current participating physicians.
Also listed are the physician's address, phone number, languages
spoken and hospital affiliation.
- Contact Preferred Choices PPO Customer Service. Customer Service
representatives can answer your questions about the physician.
- Age.
- Gender.
- Medical school.
- Year of graduation.
- Board certification or eligibility.
- Call the physician's office. You may wish to ask:
- Are you accepting new patients?
- Are you board certified or board eligible?
- How long have you been in practice?
- Do you offer extended evening or weekend hours?
- What is the procedure for getting after-hours advice?
- What are your office's on-call arrangements?
- How quickly, on average, can I get in to see you?
- Can I get a same-day appointment when I need it?
- What are your office hours?
- If you have special language needs, ask the physician's
staff what languages the physician speaks.
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Additional Links
Use these links to locate additional quality and performance information
on providers
Healthgrades
Doctor
Quality
The
American Medical Association
The
American Osteopathic Association
The
Michigan Department of Consumer and Industry Services
Certified
Doctor
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