Our robust network includes 95% of Michigan providers

As Michigan's top-ranked statewide health plan, providing access to affordable and excellent care for more than 600,000 members is fundamental. We have 95% of Michigan's health care providers in our networks, and we work hard to bring more choices to employers seeking quality health care options for their employees.

We're always looking to add qualified providers to our networks. In fact, in 2010 we added more than 1,000 doctors to our PPO and HMO/POS networks in Eastern Michigan alone.

Careful scrutiny leads to high quality and lower costs
But we're careful to add the right providers. Offering affordable and excellent care means making sure that our doctors meet strict guidelines set forth by national credentialing organizations. Providers must:

• Have current state medical and controlled substance licenses
• Have a current federal Drug Enforcement Administration (DEA) license
• Provide professional liability insurance coverage and claims history
• Hold current and previous hospital membership in our network
• Pass queries for adverse licensure actions, Medicare/Medicaid sanctions, criminal activities and disciplinary actions or malpractice

It makes a difference: Credentialed physicians typically follow evidence-based care guidelines that, in the long run, reduce the amount of unnecessary long-term health care costs. So, with high-quality doctors you get high-quality care and lower per-capita costs over the long term.

Bottom line: We'll never have 100% of the state's providers, and you wouldn't want us to.

Topics: Provider network