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How Do I Choose the Best Managed Care Provider?

Nicole Madison
Nicole Madison
Nicole Madison
Nicole Madison

When you are trying to choose the best managed care provider, two of the most important factors to consider are the terms of your coverage and whether a provider is approved in your health plan's network. Some managed care plans only cover services provided by an approved medical professional, but others cover the services of providers outside the network as well. It also is important to research a provider beforehand to ensure he is board certified and that he has not faced any sort of serious disciplinary action. Other considerations include a provider's proximity to your home or work, as a this can affect the convenience of scheduling medical visits, and choosing the correct type of medical professional you need for your unique health condition.

Often, people choose a managed care provider based on the proximity of his office to where they live or work. This can prove a good method of choosing, as you may want to ensure that you can get to your doctor without getting stuck in a lot of traffic or being seriously delayed because of bad weather. You may do well, however, to avoid choosing based on this alone. Instead, you may want to research a provider's credentials, learn whether he is board certified or not, and determine whether he has experience in addressing your type of medical needs.

Deciding the things that are important in a managed care plan is essential to choosing the best coverage.
Deciding the things that are important in a managed care plan is essential to choosing the best coverage.

Your efforts to choose the best managed care provider will likely also include deciding which type of medical professional you need. For regular care, well visits, and illnesses or injuries that develop over the course of your lifetime, you will likely need a primary care provider, such as a family doctor or nurse practitioner. If, however, you are in need of a medical practitioner who can provide care for an illness, injury, or condition that is beyond the scope of a primary care provider's expertise, you may need to see a specialist instead. For instance, a cardiologist is usually the best choice for dealing with heart-related conditions, and an obstetrician is best if you are expecting a baby.

While you can check a provider's credentials and learn whether he has faced any disciplinary action from a medical board, you cannot judge how well you will get along with him just by reading about his background. As such, you might want to arrange a consultation with the doctor you are considering as part of the selection process. You can also search for practitioner reviews and ask friends and family members to recommend a managed care provider with a good bedside manner.

Nicole Madison
Nicole Madison

Nicole’s thirst for knowledge inspired her to become a WiseGEEK writer, and she focuses primarily on topics such as homeschooling, parenting, health, science, and business. When not writing or spending time with her four children, Nicole enjoys reading, camping, and going to the beach.

Learn more...
Nicole Madison
Nicole Madison

Nicole’s thirst for knowledge inspired her to become a WiseGEEK writer, and she focuses primarily on topics such as homeschooling, parenting, health, science, and business. When not writing or spending time with her four children, Nicole enjoys reading, camping, and going to the beach.

Learn more...

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    • Deciding the things that are important in a managed care plan is essential to choosing the best coverage.
      By: kirillica
      Deciding the things that are important in a managed care plan is essential to choosing the best coverage.