Your plan requires that you choose a Primary Care Physician. That physician will be responsible for providing and coordinating your health care. Please click link for physician list. If you wish to change your Primary Care Physician, please contact Swedish Covenant Physician Partners at (773-271-0880) and we will make the necessary adjustment and/or direct you appropriately.
A Women’s Principal Health Care Provider (WPHCP) is an obstetrician/gynecologist (OB/GYNE) who has been selected to be directly accessible for treating and coordinating a female Member’s health care needs. Your WPHCP should coordinate care with your Primary Care Physician. You may access this physician without a referral; however, a referral is necessary for all services this physician recommends. Please make sure the WPHCP you have selected is on the enclosed list. Please note that these OB/GYNE providers do not take the place of your Primary Care Physician.
Your PCP will coordinate your overall health care and determine the needs for specialty care referrals for medically necessary services. You must obtain a written or electronic referral from you PCP before obtaining care from another health care provider. Such referrals include specialists and outpatient procedures provided by Swedish Covenant Physician Partners providers. Failure to obtain a referral may result in denial of payment. All referrals undergo a review process. If a referral is denied, the reason for the denial, the alternative treatment, a telephone number for questions and the mechanism for an appeal will be communicated to in writing.