The Personal Choice Network (PCN) is Blue Cross and Blue Shield of Alabama's primary care network. PCN is committed to total quality care for our members.

Be sure to read:

• Important Information About the Personal Choice Network
• Important Information Regarding Referrals

Each member and all eligible dependents select a primary care physician (PCP) and all specialist care must be coordinated through PCP referrals.

Responsibilities and expectations of the PCP include:

• Accessibility and accountability in initiating the evaluative management process.
• Point of entry for the patient into the healthcare delivery system, providing the initial patient assessment and managing all aspects of patient care within the PCP's scope of practice.
• Appropriate communication and follow-up with referred-to specialists.
• Healthcare Resource Manager to ensure cost-effective, medically necessary, quality healthcare through:
  • Preventive Care
  • Appropriate Emergency Room Referrals

• Coverage, patient access and triage 24 hours a day, 7 days a week. The following practices are unacceptable:
  • Answering machines or answering services that direct the patient to the emergency room after hours
  • Making the patient decide whether the situation is a medical emergency or not
• Physician triage for acute/urgent conditions to prevent inappropriate emergency room utilization.
• Referral to in-network providers only. Requests for exceptions should be directed to Level III Review.
• Referrals entered by PCP's administrative staff into the Blue Cross and Blue Shield of Alabama system in a timely manner, no later than 72 hours from the date of service. Retroactive referrals are only allowed for PCP or staff error.