Health Plan Information
Which health plans does MPMG accept?
I am over 65 years of age, and I don’t like my Medicare Advantage plan. What are my options?
How do I obtain an insurance card?
How do I change my primary care physician?
Do I need to notify MPMG of an address change or will my health plan take care of the notification?
Medical Services
How do I choose a primary care physician (PCP)?
How do I get my care within MPMG?
Can I still keep my MPMG physician even if my health plan changes?
What do I do if I need to see a specialist or other health care provider to obtain health care services?
Why do I have to see my primary care physician before seeing a specialist?
If I am not satisfied with the care I am receiving from my physician, how do I file a complaint?
I need to have lab work done. Where can I go?
Hospitals
Which hospitals may I use as an MPMG member?
Who coordinates my care in the hospital?
Emergency Services
How do I access emergency services?
Are there benefits to using the MPMG Extended Care Clinic instead of an emergency room?
Billing and Other Issues
How do I contact Mills Peninsula Medical Group?
How can I get information about my health plan premium?
What do I do if I receive a bill for services that were authorized and I was eligible at the time of service?
What should I do when a visit request to a specialist or other health care provider is denied and I am not in agreement with the denial?
Health Plan Information
Which health plans do MPMG physicians accept?
MPMG physicians accept a variety of health plans. Please click here for a complete listing of MPMG contracted health plans. Please click here to learn more about the various health plan types available.
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I am over 65 years of age, and I don’t like my Medicare Advantage plan. What are my options?
Medicare plans are slightly different than employee-sponsored health plans. You may choose between different Medicare Advantage plans or traditional Medicare. Before making any decisions about health plan changes, we suggest that you speak with your doctor to make sure your decision does not impact your care. For more information on senior health plans, please click here.
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How do I obtain an insurance card?
Insurance cards are issued by each health plan to its members. Please contact your health plan after you enroll to obtain a card.
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How do I change my primary care physician?
To change your primary care physician, please contact your health plan. Your health plan’s contact information is located on your insurance card and is available on the health plan’s website which you may access via our website. Physicians may belong to more than one medical group, so please indicate MPMG as your preferred medical group when selecting your physician.
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Do I need to notify MPMG of an address change or will my health plan take care of the notification?
You should call your health plan to make any changes or corrections. Your health plan will in turn notify MPMG. You should also notify your PCP's office of any address changes. This will ensure that all authorizations will be sent to you in a timely manner and will avoid any scheduling delays. You may contact MPMG for assistance by emailing customerservice@mpmg.com or calling 650-240-8059 option 1.
For a more detailed explanation of health plans, please click here. For a more detailed understanding of senior plans, please click here.
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Medical Services
How do I choose a primary care physician (PCP)?
Choosing a primary care physician is one of the most important decisions you make. For more information on selecting a primary care physician, please click here.
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How do I get my care within MPMG?
All care must be provided or coordinated by a primary care physician. Female members may self refer to an MPMG OB/GYN for all routine OB/GYN care.
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Can I still keep my MPMG physician even if my health plan changes?
Many Mills-Peninsula Medical Group physicians accept a wide range of insurance and payment options, so even if your health plan coverage changes, it is likely that you will be able to keep your MPMG physician.
If you are an HMO or PPO/EPO patient, we suggest that you call your health plan and notify them that you would like to retain your current MPMG physician, or search for your MPMG physician in your new provider directory.
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What do I do if I need to see a specialist or other health care provider to obtain health care services?
Whenever your primary care physician wants you to see a specialist or obtain other health care services such as physical therapy, special x-ray tests like CT scans or MRI, or durable medical equipment (DME), your primary care physician fills out a referral/authorization request form. Requests for referrals/authorizations are reviewed by our Medical Management Department to determine benefits and medical appropriateness.
Most routine referral/authorization requests are processed within 2 days. Urgent requests are usually processed within 24 hours. You will be sent written notification of the referral/authorization status within 2-3 working days after the request has been reviewed.
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Why do I have to see my primary care physician before seeing a specialist?
Your primary care physician can assess your medical condition and determine the appropriate specialty care, because he/she coordinates your care and knows your specific health problems.
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If I am not satisfied with the care I am receiving from my physician, how do I file a complaint?
Concerns, complaints, or inquiries may be directed to our Member Services Department. Staff is available by phone from 9:00AM to 5:00PM weekdays at: 650-240-8059. You may also file a complaint with your health plan's Member Services Department. Your health plan’s contact information is located on your insurance card and is available on the health plan’s website which you may access via our website. Your health plan will contact MPMG and work with MPMG to resolve your complaint.
If you are not satisfied with the outcome of your complaint, you have a right to complain to the Department of Managed Health Care, which is responsible for regulating healthcare service plans, at their toll-free telephone number 888.466.2219. The hearing- and speech-impaired may use the California relay service's toll-free telephone number 877.688.9891 (TDD) to contact the department. The department's Web site (www.hmohelp.ca.gov) has complaint forms and instructions online. For Medicare +Choice members, a resource to assist you is the Medicare Rights Center, at 888.HMO.9050 and Medicare at 800.MEDICARE. The hearing- and speech- impaired may use TTY/TTD: 877.486.2048.
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I need to have lab work done. Where can I go?
The names and locations of MPMG contracted labs should be located on the lab service request form provided by your physician. Please click here to see a list of additional lab locations. Please note: For all lab services, you must have a lab service request form from your physician detailing the required lab tests. The patient is responsible for paying for any lab tests provided without a referral from the physician.
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Hospitals
Which hospitals may I use as an MPMG member?
Mills-Peninsula Medical Group physicians practice at one of the leading Northern California medical centers, Mills Peninsula Health Services (MPHS). MPHS’s two campuses, Peninsula Medical Center in Burlingame and Mills Health Center in San Mateo provide a wide range of acute care, outpatient, and diagnostic services. For more information on our hospital services, please click here.
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Who coordinates my care in the hospital?
If you require inpatient hospital care, your primary care physician may work with a physician who specializes in inpatient care. For this reason, we have a team of physicians, called hospitalists, who specialize in hospital care. For more information, on our hospitalists, please click here.
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Emergency Services
How do I access emergency services?
If you believe that you may be experiencing a life or limb-threatening situation, you should call 911. If you or a family member is experiencing a life threatening situation such as chest pain or difficulty breathing, and you should not drive to the hospital, please call 911.
If possible, please call your doctor after calling 911.
For more information about emergency services at Mills-Peninsula Health services, please click here.
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Are there benefits to using the MPMG Extended Care Clinic instead of an emergency room?
Yes, there are many benefits to using our Extended Hours Clinic versus an emergency room. These may include, lower co-payments (please check with your health plan for specifics), more personalized care and shorter wait time In addition, your primary care physician will be notified of your visit to the MPMG Extended Care Clinic and will be able to follow up with you sooner.
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Billing and Other Issues
How do I contact Mills Peninsula Medical Group?
If you have an inquiry, compliment or suggestion, please let us know. You may contact us by phone, mail or email, or by using our general contact form.
MPMG Member Services
Phone: 650.240.8059
Toll Free: 1.800.940.8125
Available between 8am-5pm
Fax: 650.240.0973
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How can I get information about my health plan premium?
All premiums are determined and overseen by the health plans. The contact information for your health plan can be found on your insurance card and is available through your health plans’ website which you may access via our website.
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What do I do if I receive a bill for services that were authorized and I was eligible at the time of service?
You may contact MPMG’s Member Services Department at (650) 240-8059 and a representative will assist you in resolving the matter. Please be sure to have the following information available at the time of your call: your health plan identification number, the authorization number for the services you are being billed for, the treating physician’s name or facility name, and the date of service.
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What should I do when a visit request to a specialist or other health care provider is denied and I am not in agreement with the denial?
Please refer to your denial letter for instructions on how to file a denial. Each denial letter has your health plan’s appropriate contact information.
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Last Reviewed: January 2008