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Primary Care Physicians (PCPs)

Provider Administrative Policy

Commercial Managed Care
Policy Date
April 2007
Reviewed/May 2008
Provider Type(s)


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.


Primary Care Physicians (PCPs)

The PCP is responsible for providing routine health care, including preventive health exams and treatment for illness and injury. They are also responsible for coordinating the member`s health care with other participating providers, including providing medical records to another provider participating in a member`s care.

The PCP is responsible for maintaining procedures to inform members of follow-up care, and provide training in self-care as necessary.

PCPs must follow the procedures for requesting prior authorization/referral, as necessary per each plan’s specific requirements, whenever specialty care is needed (see PAP241).

Policy History

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