Covered California Launches New Provider Tool - NBC 7 San Diego
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Covered California Launches New Provider Tool

When Californians look for an insurance plan, they can now check to see if their provider or specialist will be included



    The Covered California website launched a new version of its provider tool Tuesday, offering residents a way to check to see if their physician or specialist will be included in a potential healthcare plan.

    Special Section: Affordable Care Act

    The tool was considered slow and inaccurate when it first appeared on California's health care exchange when it launched Oct. 1 as part of the new Affordable Care Act.

    “This is a huge job, and one that hasn’t been done before, that of creating a database for providers in different plans in one central location,” said Covered California spokesperson Anne Gonzales.

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    Early Tuesday morning, the new version of the tool was rolled out through the website.

    Users must enter the physician's name and a location to find the provider in the system. By selecting the provider, they can then see the plans associated with their specific doctor or specialist. Facilities and medical groups will be added to the directory sometime in November.

    Covered California is also offering help via the phone at (800) 300-1506.

    San Diego ear, nose and throat specialist Ted Mazer, M.D. has been an early critic of ACA, known by opponents as "Obamacare.”

    Mazer showed NBC 7 how it's hard to find details about insurance plans on the Covered California website.

    "I don't exist," Mazer explained Monday referring to the Covered California site.

    According to Mazer, anyone shopping for health coverage cannot find out if their current doctor will be a provider on the health plan they're researching.

    Insurance broker Erick Lundy said the issue of the provider selection is one of the primary components consumers need to select a plan.

    “We’re almost a month into it and it’s not there,” he said.

    However, Lundy said there's no reason to panic. The public has until December 15 to enroll in an insurance program of their choice. Coverage doesn't start until January first.

    With the delay in the doctor directory, Mazer was doubtful about the process.

    "I'm not that confident that we can get where we need to be in a timely enough fashion that people can do this by Dec. 15 and make their selection with adequate information," Mazer said.

    Physicians are concerned if their patients can get to them and there are adequate numbers of physicians and specialists in the plans, Mazer said.

    "The Medical Association has been pushing for months, we'd like to know what that list is. Are there really 80-percent of physicians, as the exchange has said, that are participating or is it more like 30-percent," he asked. 

    For those consumers shopping for insurance, the Covered California Facebook page suggests it takes less than an hour to enroll in a plan by phone.

    Service centers are open weekdays 8 a.m. - 8 p.m. and Saturday 8 a.m. - 6 p.m.

    Staffers at California's healthcare exchange wanted to remind consumers that the provider list is just a guide. It's important to check with your insurance provider and the doctor specifically to make sure their provider is in the network.

    Ed. Note: NBC 7 found Ted Mazer in the Covered California tool that launched at 6:30 a.m. Tuesday under the name "Theodore Mazer"

    For complete coverage of the Affordable Care Act implementation as well as tools, calculators, state-by-state information and a detailed FAQ, visit our ACA section.