HEALTH INSURANCE
MANAGED CARE (HMO) PLAN TYPE (see below) *
Closed to New patients. Open to Established patients. Please note that Anthem Blue Cross is transitioning to Elevance and their current website erroneously states that our HMO panel is open to new patients, however we are closed to Anthem Blue Cross if the plan is HMO so verify which clinic is accepting new patients with HMO health plan.
PRIMARY CARE
New Patients: open for Anthem Blue Cross, Beech Street, Blue Cross Blue Shield, Blue Shield, GEHA, and Scripps
Open to Established patients.
AVIATION / IMMIGRATION
Regardless of network status, we are available for these medical examinations. We are also available to those who have no insurance, Kaiser, military, or Medi-Cal..
IN NETWORK
excludes HPN + tandem
includes Full PPO Network
HMO only
part B
PPO only
WORKERS' COMPENSATION
~ established patients only
~ requires insurance prior authorization
INSURANCE CHANGE
For Established patients, we are open to all of the above health plans. Please read below regarding the timeline regarding the importance of planning ahead.
PLAN TYPES
PREFERRED PROVIDER ORGANIZATION (PPO) PLANS
PREFERRED PROVIDER ORGANIZATION (PPO) PLANS
With PPO plans, no Primary Care Provider (PCP) is mandated, however it is important to have a PCP for optimal quality care. With PPO plans you can self refer and if you do, inform us so we can coordinate care and exchange information with the specialist.
We are closed to New patients for some plans so please see above for details. For Aviation or Immigration medical examinations, if we are contracted with your insurance then we will still bill them on your behalf. If you are already established with us, we are loyal and will continue you care no matter what plan you choose.
HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS
Managed Care
HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS
Managed Care
Managed Care health plans such as Health Maintenance Organizations (HMOs) require that you designate a Primary Care Provider (PCP) in an affiliated medical group. PCP = Dr. Sunita Shailam in Mercy Physicians Medical Group.
* CLOSED TO NEW PATIENTS
Since 2021, we are closed to new managed care patients. If you have an HMO health plan and were inadvertently assigned to us after 2021 and have never been here, we can still see you, however you are encouraged to change your provider your Primary Care Provider (PCP) to your previous provider in order to preserve continuity of care and would need to contact your health plan directly to change your PCP. Alternatively, you may choose a new PCP. Perlman Clinic is both an urgent care and a PCP and is able to see you while you are transitioning to your new PCP.
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OPEN TO ESTABLISHED PATIENTS
If you are our established patient and have changed insurance with automatic assignment to another doctor, you may switch back to us. As soon as you get your new insurance, call them because it takes time to for a PCP change to be effective. If you call before the 15th of the month it will be effective the following month and if you call after the 15th of the month you have to wait until the 1st in 2 months. For example, if you call 14 August it will be effective 1 September and if you call 15 August it will be effective 1 October. Plan in advance because we do not accept same month transfers.