Before we explain what a “physician of record” is for Highmark members, and why you should choose one, let’s take a quick pop quiz to review something more basic:

Question: A “PCP” is a:

  1. Primary care physician
  2. Preventive care proponent
  3. Practical, careful pal

The answer, of course, is “A” — but a PCP should be all three!

Seeing your PCP should be as comfortable as talking with an old friend. But this friend will know your health history and habits and work with you to protect and improve your health — and return you to health when something is wrong. Together, you and your PCP can prevent or manage many medical conditions, before they become serious.

Female doctor and female patientSome health plans require you to choose a PCP, but it’s a good idea for everyone, even when it’s not required by the health plan you have.

Highmark’s own Dr. Rhonda Johnson dedicated an entire blog article to the benefits of having a PCP, which include guiding you in preventive care (see sidebar), identifying and treating common medical conditions, and directing you to specialists and other needed health services. Being able to ask questions of a trusted PCP, and following through on “doctor’s orders,” also helps you take an active role in your own health.

If you don’t currently have a PCP, or are thinking about changing your PCP, we have tips on how to choose a PCP on this blog. And don’t forget that as a Highmark member, you have access to the free My Care Navigator service for help finding in-network doctors and providers, getting appointments, transferring records, and more.

How to Name a Physician of Record for Highmark

With Highmark health plans, we ask members to name a physician of record. This is the physician or physician practice or office (it doesn’t have to be a single doctor) that you rely on for routine health care services like check-ups, immunizations and screenings. Typically, this would be an internist (internal medicine doctor), pediatrician, general practitioner or family practitioner — that is, probably your PCP.

The key point is that your physician of record is someone who handles routine and primary care, and also helps to coordinate specialized care if you need it. So a specialist, like a gynecologist or an endocrinologist, even if you see them regularly, would not be your physician of record.

Identifying a physician of record is voluntary and does not affect your coverage, claims or specialist referrals in any way. But it’s easy to see the benefits of identifying a “quarterback” who will coordinate your health care, no matter what the situation might be. Naming your physician of record also helps Highmark to serve you better by helping us to understand (and compensate) the physicians who take on that extra role of coordinating care to keep their patients healthy.

You can designate your physician of record in one of three easy ways.

  1. Fill in your PCP’s name when you complete forms during your employer’s Open Enrollment period, if the option is provided. (If you purchase your own health insurance, you won’t have the option to designate a physician of record during Open Enrollment, so you’ll want to use the second or third options below.)
  2. Call the phone number for Member Service on the back of your Highmark member ID card.
  3. Register on your Highmark member website. Log in, go to Account Settings:
    Screencap of Member website Account Settings
    And then to Physician Information:
    Screenshot of Member Website Physician Information
    Fill in your “Physician ID.” NOTE: You can call your doctor’s office to get this number (it’s also their tax ID number). Or, if your doctor or provider is in network, you can click the search for your doctor link above Physician ID. This will help you find this number.
    Screenshot of Member Website Physician ID

Reasons to Name a Physician of Record

We really can’t think of any reasons not to name a physician of record, and there are several good reasons to do so.

  • It only takes a moment.
  • It helps you and Highmark to ensure that you get the best possible care, and there are no restrictions involved.
  • You can change your physician of record at any time.
  • You aren’t required to get a referral from your physician of record to see specialists (although that is often a good idea, to ensure that your physician is “in the know” and can coordinate your care across medical teams as needed).
  • You can still see doctors other than your physician of record if you choose to.

If you have questions about naming a physician of record, you can call the number on the back of your member ID card. Or let us know by submitting a comment at the end of this post (but please don’t include any personal health information).