Welcome UCSF Physicians and Patients
Many of San Francisco’s best doctors have a new home – Hill Physicians Medical Group.
The doctors of UCSF Medical Center and UCSF Children’s Hospital became part of Hill Physicians Medical Group (effective 1/1/2010). These highly regarded primary care physicians and specialists join Hill’s existing community of doctors who have been serving the City since 1995. Also joining Hill Physicians Medical Group are many doctors affiliated with Saint Francis Memorial Hospital and St. Mary’s Medical Center.
Now, over 2,000 doctors are part of Hill Physicians Medical Group in San Francisco, with more than 870 of them in private practice or clinics. This world-class team of physicians provides access to community, university and specialized hospitals.
You may have some questions about how this news affects you, particularly if you are with another medical group. These resources explain what is happening and how to make Hill Physicians – San Francisco your medical group so that you retain the easiest access to the specialists of UCSF in 2010 and beyond.
View Hill Physicians' online doctor directory here...
Call Hill Physicians for help finding a doctor at (800) 445 5747, option 2
Make Hill Physicians - San Francisco Your Medical Group.
Who is affected?
Anyone in San Francisco or Daly City who has a HMO or POS plan from Aetna, Anthem Blue Cross (California Care), Blue Shield, CIGNA, Health Net or United Healthcare/PacifiCare is included in this change. The change is effective as of January 1, 2010.
What do I need to do if I have a UCSF primary care physician?
UCSF primary care members who have coverage through Anthem Blue Cross (California Care) or PacifiCare (United Healthcare) should call their plan to request assignment to Hill Physicians – San Francisco. The other plans will automatically transfer UCSF primary care patients to Hill Physicians – San Francisco without disruption. The phone numbers for Anthem Blue Cross and PacifiCare by United Healthcare are below.
How do I know which medical group I belong to?
Look at the insurance card from your HMO. It lists the name of your primary care physician and a medical group. If you don’t see “Hill Physicians – San Francisco” listed on your new card for 2010, then contact your health plan to make the switch. They will update their records and issue you a new card. There’s no interruption in your insurance coverage or change in your cost as a result of switching.
Can I keep the same doctor even if I switch medical groups?
Some doctors belong to more than one medical group. If your doctor belongs to both Hill Physicians and Brown & Toland, then you can remain with that physician. However, you should still contact your health plan to request that your medical group assignment be through Hill Physicians – San Francisco in order retain unrestricted access to the specialists of UCSF in all scenarios. Health plan phone numbers are listed below.
What do I need to do if my primary care physician is with Brown & Toland?
You may remain with that primary care physician but any treatments by UCSF specialists may need to be pre-approved through Brown & Toland’s administrative review and authorization process. They may approve the referral or redirect you to a non-UCSF specialist, subject to their policies. Some patients are exempt from this transition. Patients who require pediatric specialty and obstetric care, patients covered under state-defined continuity-of-care provisions or patients who saw a UCSF specialist between July 1, 2009 and December 31, 2009 and require continuing care in 2010 will be able to continue seeing their UCSF specialists regardless of PCP affiliation and without prior authorization. The continuity-of-care and referral agreement exceptions can be viewed here.
Do all Hill members have open access to UCSF Specialists?
The affiliation is for the San Francisco/Daly City portion of Hill Physicians network (Hill Physicians – San Francisco). Consumers must choose a Hill Physicians primary care doctor in San Francisco or Daly City to have the easier access to UCSF that this agreement provides. Hill Physicians members with a PCP outside of the San Francisco Region may access UCSF through a referral and authorization process if the service is not available from a physician in their area.
If I decide to change primary care physicians, how do I find one with Hill Physicians - San Francisco?
We make it easy to find a physician through the use of our online directory or through our call center which can assist you one-on-one, Monday – Friday, 8 am – 5 pm. If searching online, be sure to specify “San Francisco” in the drop box for Region.
View Hill Physicians’ online doctor directory here…
Call Hill Physicians for help finding a doctor at (800) 445-5747, option 2.
How do I change my medical group designation?
Let your health plan know that you want your medical group switched to Hill Physicians – San Francisco. Many people made the change during open enrollment, but you can switch medical groups at any time. The health plan will update their records and issue you a new card in a few weeks. There’s no change in your cost and no interruption in your insurance coverage. A list of health plan phone numbers is below:
|
Aetna
(800)756-7039, toll free |
Anthem Blue Cross
(800)333-0912, toll free |
|
Blue Shield
(888)568-3560, toll free |
CIGNA
(800)244-6224, toll free |
|
Health Net
(800) 638-3889, toll free |
PacifiCare, a United Healthcare Company
(800)624-8822, toll free |
What is the difference between a referral and an authorization?
A referral is made from one doctor to another, usually from your primary care physician to a specialist. It is for the purpose of an evaluation by the specialist. That specialist may then recommend certain treatments or services, which may require an authorization. Your physicians will handle the referrals and authorization processes. If you have existing referral and authorizations to non-UCSF, non-Hill providers, please see the additional details below.
I have a UCSF PCP and an authorization to see a non-UCSF, non-Hill specialist. What happens to that?
If a new Hill Physicians member has a Brown & Toland authorization for treatment at the time of the transfer (1/1/2010), Hill Physicians will honor the authorization for treatment with the selected specialist. When that authorization reaches its expiration date (as noted on the authorization form), then any subsequent authorizations would be reviewed by our standard policies.
What are the Continuity-of-Care provisions?
Patient safety is the top priority to Hill Physicians, UCSF and Brown & Toland. Patients who meet other continuity-of-care guidelines at the time of the January 1, 2010 transition will continue to have access to UCSF specialists regardless of medical group affiliation.
Generally, patients with the following circumstances can continue their care for a period of time with the specialist they are seeing now:
- A serious chronic condition - for up to 12 months
- Terminal illness - through completion of treatment
- Pregnancy - through birth
- Scheduled ambulatory surgery (within 180 days of 1/1/2010) - through surgery; and
- Very young children (up to 36 months) – for up to 12 months.
If you have a question about whether you are included in continuity-of-care provisions, consult your health plan.
What about the referral agreement between Brown & Toland and UCSF include?
UCSF negotiated a referral agreement with Brown & Toland Medical Group that covers certain HMO patients for a two-year period beginning Jan. 1, 2010.
Except as noted below, referrals from Brown & Toland primary care physicians will require prior authorization to access UCSF specialty care. Exceptions are pediatric specialty and obstetrical care, patients covered under state-defined continuity of care provisions (described above), and patients who saw a UCSF specialist for care from July 1, 2009 through December 31, 2009 and require continuing care in 2010. Those patients may see a UCSF specialist without prior authorization. Questions about this agreement should be directed to UCSF or Brown and Toland.
Want to know more about the transition? View the full list of FAQ's here
Visit UCSF's help center at www.AccessUCSF.org
View the official press release about the affiliation here
Who is Hill Physicians Medical Group?
Hill Physicians Medical Group was founded in 1984 and is one of the nation’s largest independent physician associations (IPAs). We’ve had physicians in San Francisco since 1995. We are a nationally recognized leader in innovative managed health care. The Standards of Excellence Program of the California Association of Physician Groups recognizes Hill Physicians as a state-wide leader in care management practices, health information technology, accountability and transparency. Consumers who select Hill Physicians as their medical group receive value-added conveniences and services which can be viewed here...
Nearly 300,000 people across Northern California have selected Hill Physicians because of our outstanding combination of quality, convenience, flexibility and value-added conveniences.
Print an informational brochure about Hill Physicians.
We’re Happy to Answer Your Questions.
We understand you may have questions. Hill Physicians Medical Group and UCSF are here to help.
Call:
UCSF at (888) 689-UCSF (8273)
Monday through Friday, 8 a.m. - 5 p.m.
or
Hill Physicians Medical Group at (800) 445-5747, and choose option 2.
Monday through Friday, 8 a.m. - 5 p.m.
View www.AccessUCSF.org to learn more
Important Information for San Francisco-based physicians
If your practice is interested in joining Hill Physicians, submit the application request form below to indicate your interest (for new San Francisco/Daly City physicians only).
Application for San Francisco/Daly City Physicians
Practices outside San Francisco/Daly City, should view our membership requirements here.