The regence blue shield extended network in the state of Washington offers you the freedom to choose from many of the health care providers who participate with regence blue shield. You may use these providers without a referral if you are willing to pay a greater share of the cost. A deductible applies and you pay a copay at the time you receive outpatient services. Inside the service area, your regence blue shield plan will cover treatment by a network or non-network physician or hospital. You will receive the higher level of health benefits if you notify us within 24 hours or as soon as reasonably possible, and you agree to follow our managed guidelines.