Government Sponsored Programs

We are currently accepting limited new patients to our practice who have Government sponsored health insurance such as Medi-Cal. We will continue to see our current patients who have had a change from private insurance to a Government sponsored program. In certain instances, we may accept a newborn patient with a specific referral from a physician. Please contact the office if you have questions regarding your health insurance options.

See the bottom below for Covered California participation.


PPOs and EPOs

(Preferred Provider Organization, and Exclusive Provider Organizations):if this is the health insurance you have purchased, you will find in your insurance company's directory that our individual physicians are listed.

We participate in all the major northern California HMOs and with most PPOs and private health insurance plans, including MediCal through Children First Medical Group.

Here is a partial list of the PPOs/EPOs with whom we have agreements:

 Aetna

ASMED Health Partnership
Beech Street
Blue Cross - narrow networks not included
Blue Shield - narrow networks not included
Cigna - narrow networks not included
Choice Care Network (Humana)
Coventry
Employee Health Systems Medical Group
Health Payers Organization
Health Net
Integrated Health Plan
Interplan
Multipla
Pacific Foundation for Medical Care


COVERED CALIFORNIA (via the Affordable Care Act)

We are currently "in network" for the Blue Shield EPO and the Health Net PPO only. These are distinct from the PPO/EPO plans above. There have been many errors on the government website so please check with the health plan directly when in doubt. These plans are very narrow in their provider offerings and changes occur frequently. Many changes to networks occur without communication to us, so please always check directly with the health plans as our information may be delayed.



Insurance And Billing

            NOTE: Our billing address has changed effective 9/1/2017 - from a PO Box in Novato to 3300 Webster Street, Suite 1202, Oakland CA 94609 (our Oakland practice location).


Click here to view our Financial and Billing Policy.

HMOs (Health Maintenance Organizations)
We work with three Independent Practice Associations (IPAs) in order to offer a rich diversity of managed health plans, hospitals, and specialty services. The HMO insurance plan will require you to choose one of our physicians as your child's primary care physician (PCP) as well as specify to which IPA you will belong. Once you choose one of our physicians as your PCP, you can see any of our group's physicians or nurse practitioners.

We are members of the following IPAs:


Hill Physicians Medical Group

HMO Agreements include Aetna, Blue Cross CaliforniaCare, Blue Shield, Cigna, and Health Net.  We are also Health Net "Blue and Gold" providers. This is a very narrow network of physicians within Hill Physicians Medical Group. Blue and Gold is offered to employees of the University of California.  


Alta Bates Medical Group; AKABrown and Toland Medical Group

HMO Agreements include Aetna, Blue Cross CaliforniaCare, Blue Shield, Cigna, and Health Net.

Children First Medical Group
HMO Agreements include Alameda Alliance, Blue Cross MediCal, and Healthy Families.

Pacific Health Alliance
PPO Next
Prime Health Services
Provider Select
Private Health Care Systems
Sutter East Bay Medical Foundation - Diablo Division - Community Provider Network
Sutter Select (formerly Benefit & Risk Management Services)
Three Rivers PPO Network
TriCare
USA Managed Care Organization
UMR/ Sutter Select
UnitedHealth Care/PacifiCare