Provider and Hospital Directory Frequently Asked Questions

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Q:

I’m having trouble using this search tool. Who can I call for help?

A:

Please call the member services number listed on the back of your health plan ID card.

Q:

What should I do if my current provider is not in the directory?

A:

Ask your provider to contact our Network Management team at 1-800-348-9804 to inquire about a contract. Under special circumstances, we may grant you permission to continue seeing an out-of-network provider at in-network rates. For example, if a comparable in-network provider is not available in your area or if continued treatment by an out-of-network provider is medically necessary. You may call the member services number listed on the back of your health plan ID card, to see if your situation meets these criteria,

Q:

I don’t have a printer. How can I get a paper copy of my search results?

A:

Printed copies of directory search results are available upon request. Please call the member services number listed on the back of your health plan ID card.

Q:

What should I do if my PCP leaves the network?

A:

If your physician leaves our network, you may be asked to select another doctor within the network. Call the member services number listed on the back of your ID card if you would like assistance with this task.

Q:

My physician would like to know if he or she has been accepted to participate in the Martin’s Point network. Can you tell me the status of his (or her) application?

A:

To get a status update, please ask your physician to check DataPoint on our website or to contact our Network Management team at 1-800-348-9804.

Q:

Are my medical services automatically covered if my provider is listed in the directory?

A:

Even when a health care provider is listed in the directory, it doesn't guarantee that the services provided by that doctor are covered under your specific medical plan. Check your plan documents, which describe your particular plan coverage, or call the member services number listed on the back of your ID card for information.

Q:

What is a PCP?

A:

PCP stands for Primary Care Physician. Your PCP will be your source for basic care, advice and direction. Your PCP will also coordinate your total care - from preventive checkups and routine medical care to specialized care and hospitalizations.

Q:

Does everyone in my family have to share the same PCP?

A:

No. Each member of your family can choose his or her own PCP or personal doctor.

Q:

What should I do if I see inaccurate information about my doctor in the directory?

A:

Martin’s Point frequently updates this directory based on information received from providers, members, hospitals and other organizations. New information is updated as soon as possible, and no later than 30 calendar days from receipt. If you see incorrect information listed for your provider, please call the member services number listed on the back of your ID card to notify us.