This article is a continuation of The Brown & Toland Medical Group in San Francisco will no longer be a part of UCSF’s Provider Network, Part 1 Published October 1st, 2009.

What if a member doesn’t want to change medical groups and prefers to select a new PCP within Brown & Toland Medical Group?

Members who choose to select another primary care physician within Brown & Toland Medical Group, or any other medical group within their service area, can use Provider Finder on anthem.com/ca to locate a new physician.  Members who need assistance in selecting a different PCP and/or medical group are encouraged to call Anthem Blue Cross’ Customer Service department at the toll-free number listed on their ID card.  Once the member knows  the PCP they would like to be reassigned to, they need to contact Customer Service at the toll-free number on their Anthem Blue Cross membership card prior to December 31, 2009 and provide information regarding their new selection in order to be reassigned.

Will HMO members who remain with their UCSF Medical Group primary care physicians (by switching to Hill Physicians Medical Group on January 1, 2010) still have access to the same specialty care physicians (orthopedics, cardiologists, surgeons, oncologists, etc.) who were available through Brown & Toland Medical Group?

Possibly.  Many specialty care physicians are members of both Brown & Toland Medical Group and Hill Physicians Medical Group, but it is important for each individual member to confirm that the specialty care physician(s) they see regularly are also part of Hill Physicians Medical Group network.

Are PPO members affected by UCSF’s new relationship with Hill Physicians Medical Group?

No, PPO members are not affected by UCSF’s new relationship with Hill Physicians Medical Group.

What products are potentially affected by UCSF’s new relationship with Hill Physicians Medical Group?

Members enrolled in CaliforniaCare HMO, Blue Cross Plus, Power Advantage HMO, and BlueCard POS can potentially be affected by UCSF’s new relationship with Hill Physicians Medical Group.

Is the quality of Hill Physicians Medical Group comparable to Brown & Toland Medical
Group?

Yes, both Hill Physicians Medical Group and Brown & Toland Medical Group provide high-quality healthcare to their patients. The PCPs and specialists from these medical groups maintain admitting privileges to top-ranked in-network facilities.  July 2009, Hill Physicians Medical Group received the designation of “Elite” on the California Association of Physician Groups annual survey for quality and affordability. This is the highest level possible on the survey.

In addition, UCSF was ranked one of the nation’s top ten hospitals by U.S. News & World Report.

What about members assigned to Brown & Toland Medical Group who were in a course of treatment prior to January 1, 2010 with a UCSF Medical Group provider or at a UCSF facility?

Brown & Toland members who are in a current course of treatment with a UCSF Medical Group specialist or at a UCSF facility will still be able to receive treatment after January 1, 2010.  HMO members should always remember to make sure that their referrals and authorizations are in place prior to receiving any specialty or facility care, and to coordinate their care through their assigned Brown & Toland primary care physician.  Brown & Toland Medical Group will perform the necessary clinical review to determine eligibility for continuation of covered services in 2010.

What if the member has a UCSF Medical Group primary care physician (and wants to keep that physician), but sees specialty care physicians that are members of Brown & Toland Medical Group?

If a member wants to remain with their UCSF Medical Group primary care physician beyond December 31, 2009, they will need to change medical groups to Hill Physicians Medical Group.  For any specialty care needs after January 1, 2010, the member will need to be referred to a participating specialist in Hill Physicians Medical Group.  Note: Many specialists in San Francisco do participate with both Brown & Toland Medical Group and Hill Physicians Medical Group, so it is important for the member to confirm that any specialists that they use will remain available to them after January 1, 2010.

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