SUN HEALTH MEDICAL CLINIC

HEALTH INSURANCE

* PLAN TYPES

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 and cost efficiency.  With PPO plans you can self refer and if you do, inform us so we can coordinate care and exchange information with the specialist.  Unless specified, we are open to new patients for the above insurances.

HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS

MANAGED CARE

CLOSED TO NEW PATIENTS

If you have an HMO health plan and have been newly transferred to us, please call your health plan  to transfer to another physician who is accepting new patients.


OPEN TO ESTABLISHED PATIENTS

Managed Care health plans such as Health Maintenance Organizations (HMOs) require that you designate a Primary Care Provider (PCP) in an affiliated medical group.

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.  PCP = Dr. Sunita Shailam in Mercy Physicians Medical Group

NO/OTHER INSURANCE

If you have Medi-Cal or Kaiser you should go through their network (however we still evaluate patients for Aviation or Immigration).  Otherwise, many others can still be a patient here.  If you have other insurance with Out of Network benefits, we provide an estimate (see below Fees) and we charge at the time of visit and provide a receipt.  Depending on the plan, we may still bill the insurance and if we receive payment, we will refund you.  Many of our patients visiting from out of the country have traveler's insurance that will reimburse the traveler after the traveler provides them a receipt.

FEES

Primary Care

Aviation

Immigration

Health Insurance Agent