You will be receiving a member ID card in the mail (if you haven't already). Please carry it with you as you'll need it when you receive services. You can view, fax or email your member ID card right from your smartphone when you download the free app in your smartphone's app store. Providence E-Card is available for iPhone, iPad and Android devices. A four digit PIN and your member identification number are required to access this app. The PIN is located on the bottom right hand corner on the back side of your member ID card.
Start off on the right foot and maximize the value of your membership:
- If you already have a primary care provider, check to be sure he or she is in your provider network.
- If you don't have a primary care provider, search the provider directory to find someone who meets your preferences and call to schedule a new patient appointment.
*If you are a Choice or Connect plan member, you'll want to choose a medical home.
- Communicate your medical home selection(s) to us via one of the following: 1. myProvidence (upon enrollment and creation of a free myProvidence account); 2. Medical home selection form (PDF); or 3. A call to customer service: 503-574-7500 or 800-878-4445 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m.
- Your medical home care team will provide and manage your care, including referrals to specialists as necessary.
- Your care team will contact you to inform you about available health resources and ways to communicate with your care team.
Step 2: Register for or log in to www.myProvidence.com, your secure health management website.
- Review your member materials, which include information about your benefits, rights and responsibilities, privacy practices and protected health information and disclosure.
- Complete a confidential personal health assessment to easily identify potential health risks and improvements you'd like to make to your health.
- View your claims history, participate in wellness challenges, estimate medical costs and much more.
Step 3: Understand when and where to receive different types of care.
- ProvRN, your free, 24/7 nurse advice line – a registered nurse can assess your symptoms to help you figure out your next steps for care.
- Providence Express Care Virtual lets you see a board-certified provider right away, from anywhere. All you need is an internet connection and a computer, smartphone or tablet. Providers can treat common health issues including cold and flu, eye infections, skin irritations, and joint issues. No appointment is needed. For questions about Express Care Virtual benefits coverage, contact Providence Health Plan Customer Service at 800-878-4445 (TTY: 711), Monday through Friday, 8 a.m. to 5 p.m.
- Immediate care is for treatment that is needed right away and is non-life threatening (e.g., minor cuts or burns; ear, nose and throat infections; sprains or strains; headaches or dizziness). These conditions can be treated at an immediate (non-emergency) care facility.
- Emergency care is most appropriate for accidents or sudden, unexpected injuries or illnesses that may result in serious medical complications, permanent disability or death if treatment is not sought immediately (e.g., severe chest pain, loss of consciousness, bleeding that doesn't stop, severe abdominal pain, sudden paralysis or slurred speech, etc.). In the event of an emergency, call 911 or go directly to the nearest emergency facility.
Tip: Be prepared and locate the nearest immediate care and emergency care facilities by using the online provider directory.
If you selected prescription drug coverage, refer to your member materials for your benefit information. To save money, be sure to choose generic medications and use participating pharmacies.
Visit www.ProvidenceHealthPlan.com/pharmacy for access to pharmacy resources including articles and forms, the formulary, information about generic and specialty medications, coupons for free first-fill medications and answers to frequently asked questions.
The Explanation of Benefits, or EOB, explains how a claim was processed. It includes benefit payment information as well as information specific to the claim, such as service date, type of services and provider name. View a sample EOB with fields explained. The EOB is not a bill. You will be billed by the provider for any amount you owe for services. You have online access to your EOBs through myProvidence.
Go green! Choose paperless EOBs for medical claims. Sign up in myProvidence.
FitTogetherTM is a suite of programs and services designed to help you find your fit, at home, work, with family and friends. From managing stress and other health conditions to recreational discounts and recipes, you'll find what you need to find your fit. Members also receive discounts on cultural activities, Providence-offered classes, gym memberships, acupuncture, massage therapy, LASIK and hearing aids.
Call us at one of the numbers listed below.
- Customer Service: 503-574-7500 or 800-878-4445 (TTY: 711), available Monday through Friday from 8 a.m. to 5 p.m.
- ProvRN free nurse advice line: 503-574-6520 or 800-700-0481, available 24 hours a day, seven days a week.
- Providence Resource Line, register for Providence classes: 503-574-6595, available Monday through Thursday from 8 a.m. to 6:30 p.m and Friday from 8 a.m. to 5:30 p.m.
- myProvidence help desk: 503-216-6463 or 877-569-7768, available 24 hours a day, seven days a week.