Finding a new healthcare provider can be a stressful or exciting moment. Maybe you urgently need help for your mental health, maybe you’ve moved somewhere new, or perhaps you are expecting a baby and need a new type of healthcare. Whatever the reason, we want you to have a quick guide to getting started with this process.
Keep in mind that there are different approaches to finding a provider. If you want to keep things simple, you’ll still need to budget about 30 minutes for your search. If you want to get into more details about each provider, that can take longer. Breaking it up over a few days or getting help from a family member can ease the process a bit.
So get out your laptop or phone, have your insurance card ready, grab a pen and paper or open a new blank document – and maybe put a few happy snacks within reach.
What provider do you need?
This article contains general guidance for finding any type of healthcare provider. If you need more specifics about any of these types of care, please check out the links below. These articles offer additional steps that you can combine with our general guidance.
- Women’s Health & Gynecology
- Obstetrics, Midwifery, & Pregnancy
- Fertility
- Menopause
- Pediatrics
- Mental Health
- Lactation
Getting to Appointments/Location
Travel to and from appointments is a big deal. Before you start your search, you need to have an idea of how much time and distance you’re able to manage. This is especially true if you need help getting to and from those appointments due to disability, lack of personal transportation, or cost.
You may also prefer a specific hospital or clinic based on your location, transit, or quality of care you’ve experienced. It’s also possible to look up the quality data of a hospital or healthcare system through your state health department or national organizations like CMS or the Leapfrog Group. Note those location preferences down – it can be really helpful for narrowing your search.
Call or Message your Insurance Company
The fastest way to work on the next step is to call your insurance company directly by using the number on the back of your card. Alternatively, you can message in app or on their website, but this can take much longer to get a response.
These are questions you might need to ask, although you may have others!
- Ask if the type of provider you’re looking for is generally covered.
- Do you need a referral for this type of provider?
- Can they send you a list of in-network providers of this type via email? (provide how far you can travel)
- Do you have insurance coverage for virtual visits?
Review in-network providers
Whether you’re provided a list of in-network providers or not, you’ll want to log into your insurance website to take a closer look at what’s in your travel distance. You may learn that a provider works at a hospital you prefer or that they speak a language you need. Insurance companies generally have some helpful filters like these to use and to help you weed out providers or highlight what you like.
This will help you make a short list. In some cases, your list may just be one or two names. We suggest choosing a maximum of five for the next step. Put these on your blank document or piece of paper.
Should I read reviews?
While a personal referral from a friend or another provider can be helpful, online reviews may not even require the reviewer to have met or been a patient of the provider they’re reviewing. Some reviews are paid for as well. If you want to read online reviews, exercise caution or use sites/apps that have a verification process.
Contacting Providers
In most cases, you’ll still need to call a provider directly to make an appointment. Once you’re an established patient, you may be able to do this through a healthcare app.
Try to call during regular business hours and avoid lunch time.
Explain that you’re a new patient and hope to make an appointment with “x.”
Pro tips:
- If they aren’t taking new patients, you can ask to be put on a waitlist if available.
- If they are taking new patients, expect to answer multiple questions or be sent an intake form by email or snail mail.
- Have your insurance card in hand, as they will ask for this info when scheduling a new appointment.
- If the appointment time you’re given is a long timeframe away, ask if you can be added to a cancellation list or ask if this is the number to call back to check for openings (do this weekly).
Keep track of what you find! This includes appointment dates and times, whether you need to call back to see about earlier availability, and whether you had to leave a voicemail without talking to anyone. Making multiple appointments is okay. You just want to keep track of appointments you plan to go to, calls you need to make, and canceling any appointments that you don’t need.
Reassess
After your first appointment, how did you feel?
- Seen
- Supported
- Questions welcomed
- Logistics doable long-term
If your gut is saying yes – go back to your document and you can cancel any other appointments you have made.
If you’re not sure, or know it wasn’t a good fit, then it’s okay to meet with another provider. It often takes more than one try to find the right fit. In some cases, though, your insurance may not pay for additional visits right away or will charge you differently. It can help to call your insurance company to tell them you’re switching providers and to ask about costs or how long you need to wait before another visit is covered.
Wrapping Up
In addition to the starter steps we outlined above, there are other layers you can add to your search. These include things like checking board certification, hospital privileges, specialty surgery certification and more. Our specialty article links at the beginning of the article go over deep-dive tips you can combine with this general guidance.
We also recognize that there are provider shortages in many areas. You may not feel you have a lot of choices, and in some areas or hospital systems, a provider may just be assigned to you. For more on improving relationships with existing providers, please click here.
