Blue Shield - Find a Provider

This page provides instructions on finding a provider within the Blue Shield network. 

  1. Go to the Blue Shield provider search tool: www.blueshieldca.com/prism
  2. Choose your search criteria:
    • Enter your location
    • Enter a doctor's name, specialty, or medical group
    • Choose a Plan:
      • For those currently on Anthem Choice, Care, EPO, and HDHP - Blue Shield of California PPO Network
        • ​For those currently on Early Retiree Choice, Care, EPO and Medicare PPO/Medicare EPO - Blue Shield of California PPO Network
      • For those currently on Anthem Select - Tandem PPO 
        • For those currently on Early Retiree Anthem Select - Tandem PPO
      • For out of state coverage - Blue Card PPO
        • ​Plan Code: EMF
  3. After entering your search criteria, choose "Search"
  4. A results list will be populated based on your given criteria
    • You can increase the search radius to capture a large group of providers

Tips for Searching for a Provider

You can filter your searches when searching for providers by clicking the "Filter & Sort" tab.

  • Expand your search mile radius. Blue Shield's site is defaulted to search within a 15-mile radius for providers based on the location you input. It's recommended to increase the radius to capture more providers!
  • If you know it, you can search by National Provider Identifier or License Identifier.
  • Make sure to double check if the provider is accepting new patients. Some providers may show up on your search, but may not be taking new patients and vice versa. You can filter this search by clicking or unclicking the "accepting new patients" check box.

 

See below for an alternative method of searching for a provider:

  1. Go to the Blue Shield provider search tool: www.blueshieldca.com/prism
  2. Use the tiles to select a specialty.
    • If you select the Doctors & Specialists tile, you will be prompted to further refine your search:
      • You can search by Doctor Type, Doctor Name, or Medical Group.
      • Use the drop down to refine your search.
      • NOTE: regarding Family Practice v. General Practice
        • Family Practice serves all ages and genders, so it can include pediatrics and geriatrics.
        • General Practice only takes adults and may not include as wide a range of services. You may be referred out to a specialist.
    • You may be prompted to login or continue as a guest. Select "Continue as a Guest."
  3. Next, enter your location and select "Continue."
  4. If prompted to select your plan, choose "Show Popular Plans."
    • For those currently on Anthem Choice, Care, EPO, and HDHP -- Blue Shield of California PPO Network
    • For those currently on Anthem Select - Tandem PPO 
    • Scroll to the bottom and select "Continue with this Plan"
  5. A results list will be populated based on your given criteria
    • You can increase the search radius to capture a large group of providers
  6. For Mental Health, you will be prompted to "Continue as a Guest", enter your location, and then select a plan. 
    • Plan Coverage Year: 2024
    • Plan Type: 2024 Employer Group Plans (101+ Employees)
    • Subplan: 
      • For those currently on Anthem Select, use the Tandem PPO
      • All other plans, use Blue Shield of California PPO Network

FAQs

If you need help using the Blue Shield Provider Search Tool, take a moment to review the Blue Shield Provider Search Tutorial Videos. There are videos on:

  • Searching for a doctor
  • Searching for a medical group
  • Checking if your primary care physician is in-network
  • Using the out-of-state provider search

Blue Shield Phone Line Now Available!

(877) 888-6055

Open through 12/31/2023, you can use this number to confirm if your medical provider is in-network or find another provider covered on your 2024 medical plan.

  • Representatives have access to the County’s 2024 Blue Shield medical plan summaries and will be able to assist with related questions.
  • Tips when calling Blue Shield:
    • Ask for a representative, then request “Find a Doctor”
    • Use employer group “PRISM – County of San Luis Obispo”
    • Group Number: W8002724
    • Use Blue Shield of California PPO Network for:
      • Blue Shield HDHP, Choice, Care, and EPO medical plans
    • Use Tandem PPO Network for:
      • Blue Shield Tandem PPO (formerly Anthem Select)

Blue Shield will take calls through 12/31/23 and you will call Accolade thereafter.

When searching for an out of state provider, you will use the Blue Card PPO network. If prompted for a plan code, use EMF.

To find the specific out of state provider search, scroll to the bottom of the Blue Shield Search page. You will go to the section titled "Accessing Care Outside CA" and choose "Providers outside of CA." 

  • This will prompt you to leave the Blue Shield website. Click to confirm and leave the website.
  • Start with choosing a location and plan:
    • Location: Enter an address, city, or zip code
    • Find your plan by prefix: Enter EMF
  • You may now search for specific doctors, specialties, facilities, etc. 

Due to SB197, providers must attest every 90 days to confirm name, address, and phone number to be included in the Blue Shield directory. It is possible the provider you are searching has not completed the attestation. 

Blue Shield recognizes the importance of maintaining a strong doctor-patient relationship when you change healthcare plans. 

Any member who has any qualifying medical condition with a non-contracted provider will be able to complete a Continuity of Care form and submit it to Blue Shield.