How to get in-network care and access the Regence provider network like a pro

It’s one of the most common questions our Regence customer service professionals get asked:

“Is my doctor in the Regence network?”

Great question!

Let’s start with some basics.

What does “in network” mean?

A provider network includes doctors, specialists, hospitals, pharmacies and other healthcare professionals and places that are part of your health plan. The Regence network of providers offers our members discounted prices.

We also make sure these providers deliver high-quality care, not just lower prices. You can read more about our provider performance ratings here.

What’s the benefit of using in-network healthcare providers?

When you use in-network providers, you pay less because we’ve negotiated discounted rates for you. That’s a benefit of, well, having healthcare benefits.

You know what to expect based on the benefit plan you picked during open enrollment. In-network care will count toward your annual deductible and out-of-pocket maximums. This is important because your deductible is the amount you pay out of pocket before your health plan starts to pay some portion of the costs. Your out-of-pocket maximum is the most amount you’ll pay in a plan year. (Insurance terminology explained here.)

In-network providers also bill directly to us, so you don’t have to file claims yourself for routine care.

What happens if I use out-of-network healthcare providers?

When you step outside the network, that’s when costs become unpredictable. Out-of-network providers won’t have the same discounted prices, may not offer the same quality services and Regence may not cover the care. So ultimately, when you go out of the provider network, you’ll end up paying more for your care.

How do I use the Regence online provider directory?

Regence offers both in-person and virtual care options for many services.

• Sign in to your account on Regence.com or the Regence app.
  • Don’t have an account? Get started.
• Choose “Find care.”
• Search by a doctor’s name, specialty or location.
• Search for places such as urgent care clinics, hospitals and pharmacies. Search by the type of place or by name.
• Pro tip: Don’t see your provider or place listed? Then they’re not part of the Regence network.
• You can filter your results in a number of ways, including those accepting new patients, by specialty, gender preference and distance.
• Pro tip: Call the provider’s office to verify information such as new patient acceptance. The provider may have initiated a change that hasn’t been recorded yet in our system.

Need help?

Find in-network providers through our live chat online or on the app. You can also call the number on the back of your member ID card to talk to a customer service professional. We’re here for you.

Bottom line: By getting care from an in-network provider and facility, you’ll save money, avoid surprise bills and get the most from your health plan.

Resources

Know where to find care while traveling, during an emergency and more