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Please be advised that the Sutter Health Group which own the Camino Medical Group - aka PAMF (located in Sunnyvale and Mountain View), Palo Alto Medical Clinic, and Santa Cruz Medical Foundation is a contract medical group with UnitedHealthcare for both EPO (Choice) and PPO (Choice Plus) plans.
However, the SurgiCenter - an outpatient surgery center, operated by the Palo Alto Medical Foundation (PAMF) is a non-contract medical facility. Furthermore, the SurgiCenter is operated independently from the PAMF; Expenses incur through the SurgiCenter will be billed separately under its own tax ID, which is not the same as the PAMF - a contract medical group. Members who enrolled in the EPO plan will be billed for non-covered expenses, and PPO plan pays 80% of UCR coverage, instead of 100%.
EPO/PPO contract providers are not required by law to refer you to other contract physicians or medical facilities. Only HMO providers are subject to this provision. To maximize your benefits, please use only contract providers.
To alleviate any unexpected out-of-pocket expense, we strongly urge you to request that the contract treating physician perform the medical procedure(s) at the nearest UHC contract facilities: El Camino (located in Mountain View) or Stanford (located in Palo Alto) Hospital. Note: all PAMF providers operated through the Sunnyvale and Mountain View offices are required to obtain clinical privilege at El Camino Hospital, and PAMF providers from the Palo Alto location are required to have clinical privilege at the Stanford Hospital.
Simply, as a patient you have the right to select your choice of care. Please do so wisely.
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