FAQs

If you have a question or issue that is not listed below, please click here to contact us or call our Customer Relations Department at 1-855-359-6323.​

Physician Network

What Is A Primary Care Physician (PCP)?
How Do I Choose A Primary Care Physician?
How Do I Change My Primary Care Physician?
How Can I See A Specialist?

Medical Group/IPA Enrollment

How Do I Choose And Enroll In Providence Care Network?
How Do I Change My Enrollment Information?

Emergencies and Urgent Care Centers

Which Hospital Do I Go To For Emergencies?
When Should I Go To The Emergency Room For Treatment?
When Should I Go To An Urgent Care For Treatment?
Which Urgent Care Facilities Can I Use?
Are There Benefits To Using An Urgent Care Center Instead Of An Emergency Room?

Hospitals / Outpatient Surgical Centers

Which Hospitals May I Use As A Member In Providence Care Network?
Who Takes Care Of Me In The Hospital?
Which Outpatient Surgery Center May I Use As A Member In Providence Care Network?

Lab and Radiology Services

Where Do I Go If I Need To Have Lab Work Done?
Where Can I Get A Mammogram?
Where Do I Go For X-Rays Or Radiology Services?

Physical Therapy Services

Where Do I Go If I Need Physical Therapy?

Referrals to Specialists and Second Opinions

Do I Need A Referral To See A Specialist?
If A Referral Is Denied, What Is My Next Step?

Pharmacies

What Pharmacies Can I Go To As A Member Of Providence Care Network?

Billing and Claims

I Am Receiving A Bill. What Do I Do?
I Believe I Have Reached My Co-Pay Maximum. What Do I Do?

Health Plans

Which insurance health plans does Providence Care Network accept?

Providence Care Network works with the leading HMO health plans to give you access to an exceptional network of independent physicians in the San Fernando Valley.

Click on the plan name to visit each health plan’s web site for more detailed information:

HMO Plans

Medicare Advantage Plans (Seniors)


Physician Network

What is a primary care physician (PCP)?

A primary care physician (PCP) is responsible for coordinating all of your healthcare needs, including managing your annual exams, preventative care, routine illnesses and minor injuries, prescription medications and referrals to specialists and hospitals.

How do I choose a primary care physician?

Your choice of a PCP is important. To see a list of our physicians and learn more about their specialties and office locations, check our Physician Directory. You may also contact our Customer Relations Department or your health plan’s member services department for further assistance. Some physicians may belong to more than one medical group, so be sure to clearly indicate Providence Care Network as your medical group when you select your physician.

How do I change my primary care physician?

You must contact your health plan directly to change your primary care physician. The contact information for your health plan is on the back of your insurance card or you can visit the health plan’s website. Some physicians may belong to more than one medical group, so be sure to clearly indicate Providence Care Network as your medical group when you select your physician. Check our Physician Directory to see a list of our physicians.

How can I see a specialist?

Certain medical conditions may require you to see a specialist. Providence Care Network has an extensive network of specialists and other health care providers to serve your medical needs. Prior authorization may be required prior to seeing a specialist. Some health plans give patients the ability to self-refer to certain specialty services such as Obstetrics/Gynecology. Your PCP will let you know what type of information will be needed to bring to the specialist such as medical records, test results or authorizations.

Medical Group/IPA Enrollment

How do I choose and enroll in Providence Care Network?

Your choice of a PCP and medical group is important. Assess your family’s medical needs and define the type of physician you want. Our Customer Relations department can assist you with information about Providence Care Network’s primary care and specialty physicians. They can also provide you with the Provider ID numbers needed for your health plan enrollment forms. Once you have selected your PCP, you will need to inform your Health Plan of your decision. You can also check our Physician Directory to see a list of our physicians.

How do I change my enrollment information?

You will need to contact your health plan directly if you need to change/update your address or personal information.

Emergencies and Urgent Care Centers

Which Hospital do I go to for emergencies?

For any life-threatening emergency, call 911 or go directly to the nearest hospital emergency room.

When should I go to the emergency room for treatment?

In a life-threatening situation, always call 911 or go to the nearest emergency room. Life-threatening situations are those medical situations that may result in permanent physical impairment or death if not treated immediately, such as chest pains, excessive bleeding and broken bones. You do not need to wait for authorization to visit the emergency room. However, you must inform your primary care physician and health plan, usually within 48 hours of your visit.

When should I go to an urgent care for treatment?

If your urgent medical need occurs during your doctor’s office hours:
In non-life-threatening situations, first contact your primary care physician and describe your symptoms. Your physician will advise you on the appropriate course of action.
If your urgent medical need occurs after your doctor’s office hours:
In non-life-threatening situations, you can contact your primary care physician’s office and their answering service can assist you in talking to your doctor or direct you to someone who can help you.
You may also visit one of Providence Care Network’s contracted Urgent Care facilities. Please see available list under our Urgent Care Centers tab.

Which urgent care facilities can I use?

Providence Care Network has contracted with the following facilities for extended or urgent care services. These facilities offer convenient access for non-life threatening urgent medical needs.

Pediatric Acute Care Medical Associates

5353 Balboa Blvd., # 201
Encino, CA 91316
Ph: 818-788-5437
Mon – Fri: 6:00 p.m. – 12:00 a.m.
Sat & Sun: 12:00 p.m. – 8:00 p.m.

Reseda Family Clinic & Urgent Care Center

6830 Reseda Blvd.
Reseda, CA 91335
Ph: 818-996-4888
Mon – Fri: 9:00 a.m. – 8:00 p.m.
Sat & Sun: 9:00 a.m. – 5:00 p.m.

Are there benefits to using an Urgent Care Center instead of an Emergency Room?

Yes, following are some of the benefits to using an Urgent Care Center versus an emergency room:

  • Lower co-payments (contact your health plan to verify your benefits & co-payments)
  • Wait times are usually shorter
  • No appointment is necessary
  • More personalized approach to care

Hospitals / Outpatient Surgical Centers

Which hospitals may I use as a member in Providence Care Network?

As a member of Providence Care Network, you have access to Providence Tarzana Medical Center, which is one of the best hospitals in the San Fernando Valley and nationally recognized for quality and safety. If you have a need for hospital care, your physician will arrange the services that best meets your needs.

Who takes care of me in the hospital?

Providence Care Network wants to make sure that your hospital stay is a positive, healing experience, that is why PCN has inpatient care teams of doctors called “hospitalists” who partner with your primary and specialty physicians to care for you while you are hospitalized. Our mission is to coordinate and oversee your care that is delivered with compassion and excellence to get you well and home to your family and loved ones.

Which outpatient surgery center may I use as a member in Providence Care Network?

As a member of Providence Care Network, you have access to the Providence Tarzana Medical Center’s - Outpatient Surgical Center which is located on the campus of Providence Tarzana Medical Center. Your physician will arrange will arrange the services that best meets your needs.

Lab and Radiology Services

Where do I go if I need to have lab work done?

For all lab services, you must have a lab service request form from your physician detailing the requested lab tests. The name of the lab and the phone number will be listed on the lab service request form provided by your physician.

Providence Care Network contracts with Quest Diagnostics for all of its outpatient lab services. Please see the attached link to find a convenient testing center near you.

Where can I get a mammogram?

Providence Care Network proudly offers Providence Women’s Center, which is nationally recognized for women’s health. When you receive a referral for a mammogram from your physician, the referral authorization will include information on how to contact Providence Women’s Center.

Where do I go for x-rays or radiology services?

Providence Care Network offers the following nationally recognized centers for diagnostic radiology services:

  • Providence Tarzana Imaging Center
  • Providence Tarzana MRI Center
  • Providence Tarzana Medical Center

All radiology services are located on the campus of Providence Tarzana Medical Center. Your physician will discuss the need for these types of services with you and will provide the necessary referral information.

Physical Therapy Services

Where do I go if I need physical therapy?

Providence Care Network members have access to Providence Outpatient Therapy Center. Your physician will discuss with you any requirements for physical therapy services and will provide you with the necessary referral information.

Referrals to Specialists and Second Opinions

Do I need a referral to see a specialist?

Yes, referral authorizations are required prior to seeing a specialist. A referral is a written communication that enables your primary care physician (PCP) to send you to a specialist that participates in Providence Care Network. Your physician may refer you to a specialist whenever your condition warrants specific specialty services. Providence Care Network has an on-line electronic referral program that facilitates timely referrals.

If a referral is denied, what is my next step?

If you receive a letter in the mail denying a requested service, the document will include instructions regarding your appeal rights as a patient. You may also contact Providence Care Network’s Customer Relations Department at 1-855-359-6323 or your health plan’s member services department for additional assistance.

Pharmacies

What pharmacies can I go to as a member of Providence Care Network?

Pharmacy benefits are administered through your health plan. You can contact your health plan for information on your pharmacy benefits or applicable co-payments and a list of available pharmacies.

Billing and Claims

I am receiving a bill. What do I do?

Contact Providence Care Network’s Customer Relations Department at 1-855-359-6323 and inform them of the type of bill you received. They will help determine if this was billed to you in error or if this amount is part of your co-insurance or co-payment benefit responsibility.

I believe I have reached my co-pay maximum. What do I do?

Contact your health plan’s member services department directly to determine if you have reached your co-payment maximum. That number can be found on the back of your insurance card.