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Frequently Asked Questions

Important Note to All Patients

All of our patients are welcome to contact our Customer and Member Services Department during standard working hours to have their questions answered. For your convenience, we have listed here many of the questions we receive most often along with our responses. If you cannot find the answer to your question among these, please contact:

Customer and Member Services
Cedars-Sinai Medical Group
Phone: (800) 773-2742

If you are confused about how the healthcare system works, about certain terms and phrases or how Cedars-Sinai Medical Group fits into the healthcare system, visit Healthcare Questions and Answers for a brief discussion about the state of healthcare today.

General

  • What is the difference between Cedars-Sinai Medical Group and Cedars-Sinai Health Associates?
  • Which health plans do you accept?
  • Why can't I check my lab results or consult with my physician through e-mail or the Internet?

Choosing and Seeing a Physician
  • My company changed healthcare insurers. Can I keep my current Cedars-Sinai Medical Group or Cedars-Sinai Health Associates physician?
  • How do I choose a primary care physician if I don't know anything about him or her?
  • How do I change my primary care physician?
  • If my primary care physician's office schedule is full and I feel I need care, can I go to the emergency room?
  • How do I get to my physician's office?
  • Do I need to bring anything special to my first visit?

Referrals
  • Why do I need a referral from my primary care physician to see a specialist?
  • My physician submitted a referral for additional care. How do I find out the status of that referral?
  • My referral was denied. How can I appeal?

Billing
  • I received a bill and have questions about it. Who can I call for assistance?
  • What should I do if my insurance information is incorrect on my statement?
  • Can I pay by credit card?
  • I called the Business Office once before, but my issue continues. What should I do?
  • According to my Explanation of Benefits (EOB), I am only liable for a certain amount of money and the balance is to be written off, as my physician is a participating provider. What should I do if my bill does not reflect this?
  • May I speak to someone in person?
  • May I e-mail you my concerns?
  • It has been several months since I saw my physician and I am only now receiving a bill. Why?
  • Why do patients get more than one bill?

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General

What is the difference between Cedars-Sinai Medical Group and Cedars-Sinai Health Associates?

The Cedars-Sinai Medical Group is a multispecialty medical group located at five sites, with an urgent care facility at 8501 Wilshire Blvd., Ste 150 to serve afterhours adult medical requirements. This urgent care facility is open afterhours from 5 to 8 p.m. Monday through Friday and 9 a.m. to 1 p.m. Saturday.

Cedars-Sinai Health Associates is an independent physician association with a network of physicians who have individual offices throughout Los Angeles. After hours care is generally provided through the Emergency Department at Cedars-Sinai Medical Center or the nearest hospital, depending on the medical necessity.

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Which health plans do you accept?

Both Cedars-Sinai Medical Group and Cedars-Sinai Health Associates physicians accept many forms of payment, including self-pay, indemnity insurance, Medicare fee-for-service and various HMO products. A Member Services representative can help identify if your plan is accepted by your physician. Because our medical groups and physician associations accept a variety of health plans, you might be able to maintain your relationship with your physician even when it is necessary to change your health plan.

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Why can't I check my lab results or consult with my physician through e-mail or the Internet?

At Cedars-Sinai Medical Network, we are respectful of the fact that healthcare is an extremely private activity. We are not yet confident that the appropriate systems can be put in place to protect your privacy when exchanging personal healthcare information over the Internet. In 1996, the U.S. Congress passed a bill that specifically addresses patient confidentiality and Internet activity (the Health Insurance Portability and Accountability Act). The government is developing regulations that will help guide us in providing healthcare information over the Internet. Once we are sure no one but you can access your private information, we will allow physicians to communicate with you over the Internet about your care as appropriate.

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Choosing and Seeing a Physician

My company changed healthcare insurers. Can I keep my current Cedars-Sinai Medical Group or Cedars-Sinai Health Associates physician?

Because our medical groups and physician associations accept a variety of health plans, you might be able to maintain your relationship with your physician even when it is necessary to change your health plan. Please contact our Member Services Department as soon as you learn your company is switching plans.

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How do I choose a primary care physician if I don't know anything about him or her?

We provide substantial information about Cedars-Sinai Medical Group and Cedars-Sinai Health Associates primary care physicians on this website. You can search by physician or location and learn where the physician attended medical school and conducted his or her residency. Additionally, you can call our Member Services Department for information about our physicians at (800) 700-6424 for Cedars-Sinai Medical Group or (800) 773-2742 for Cedars-Sinai Health Associates.

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How do I change my primary care physician?

If you are a current HMO patient of Cedars-Sinai Medial Group, our Member Services Department can help you change primary care physicians. If you are a member of Cedars-Sinai Health Associates, Member Services can help you choose a physician, but you must contact your health plan directly to make the change official.

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If my primary care physician's office schedule is full and I feel I need care, can I go to the emergency room?

Our physicians are available 24 hours a day. If your direct primary care physician is not available, another high-quality, caring physician who has the authority to send you to the emergency room will be available. We ask you to always contact your primary care physician when possible before going to an emergency room. If you or someone under your care is experiencing a life-threatening emergency, call 911. Should you require care outside the Cedars-Sinai Medical Group's service area, please obtain copies of all tests taken and contact your physician as soon as possible to determine the best course of care.

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How do I get to my physician's office?

Cedars-Sinai Medical Group and Cedars-Sinai Health Associates physicians are located throughout greater Los Angeles. Our website offers MapQuest services to assist you finding the best route from your home or office to your physicians. If you do not know your physician's address, call our Member Services Department at (800) 700-6424 for Cedars-Sinai Medical Group or (800) 773-2742 for Cedars-Sinai Health Associates.

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Do I need to bring anything special to my first visit?

We want to ensure you are seen quickly once you arrive and that your time with the physician is used effectively. It will be helpful if you bring to all your visits your current insurance card and any medications you are taking.

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Referrals

Why do I need a referral from my primary care physician to see a specialist?

If you are insured by an HMO or in some cases a PPO your health plan will probably require a referral for specialist care. Your primary care physician is your central contact for all medical concerns as this allows for continuity of care for members and allows a central location for medical records. Referrals are typically processed within 14 days, except in urgent situations, and you will be notified by mail when the referral has been processed.

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My physician submitted a referral for additional care. How do I find out the status of that referral?

Most non-urgent referrals take about 14 days to complete and get the information to you. You and your physician will receive notification by mail when your referral has been processed. If it has been more than 14 days, please contact our Member Service Department for its status.

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My referral was denied. How can I appeal?

The first step in appealing a denied referral is for you to contact your health plan. To do this, you will need the referral number. If you do not have the referral number, contact our Member Services Department. They can provide this number and transfer you directly to the health plan.

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Billing

I received a bill and have questions about it. Who can I call for assistance?

Our billing service is ready to help you. For your convenience, we have posted answers to some of the most frequently asked billing questions on this website. If your question cannot be answered here, please contact our billing department by telephone at (800) 851-0211.

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What should I do if my insurance information is incorrect on my statement?

We apologize for this error. Please contact us during at (800) 851-0211. We will then make the necessary changes to your account and rebill the correct insurance plan.

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Can I pay by credit card?

Yes. Please fill out the appropriate information on your statement and mail it back to us. Alternatively, you may telephone our billing customer service unit at (800) 851-0211, and they will be happy to assist you with processing your payment.

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I called the Business Office once before, but my issue continues. What should I do?

In some cases, changes to a patient's account might take a small amount of time. Should you see that a requested change did not take place, please call us. Make sure you obtain the name of the representative who is assisting you every time you telephone us at (800) 851-0211 so we can track our service. If you are not satisfied with the follow-through, please ask for a supervisor.

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According to my Explanation of Benefits (EOB), I am only liable for a certain amount of money and the balance is to be written off, as my physician is a participating provider. What should I do if my bill does not reflect this?

Please contact our customer service unit at (800) 851-0211 with your information. We will be happy to review your information with your insurance carrier to ensure the correct adjustment was made.

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May I speak to someone in person?

Yes. Please contact our office at (800) 851-0211 to make arrangements to meet with one of our physician billing coordinators.

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May I e-mail you my concerns?

Yes. We recognize that our patients have very busy lives, and our Internet service allows you to quickly send us your information via e-mail. You will receive a response from us indicating that we did receive your information and we will follow through as necessary.

Send Us a Message

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It has been several months since I saw my physician and I am only now receiving a bill. Why?

Some insurance plans take up to 90 days to pay out their patient's claims. During this time, we do not send out information to our patients regarding their billing activity, as we have found this action often confuses our patients. On receipt of payment from your insurance carrier, you will receive a bill from the Business Office for any residual balance, which includes details of your insurance payment activity and other useful information.

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Why do patients get more than one bill?

For services rendered in the hospital, you might receive more than one bill, but you are not paying twice. The hospital bills for their equipment, technicians and supplies. Specially trained doctors, such as radiologists, pathologists or anesthesiologists might perform additional services at the request of your doctor. These specialists will bill you separately. If you have any questions, please call the number printed on the statement you receive from these specialists.

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