Below is a list of the patient service departments dealing with billing and registration issues. Please pick the appropriate office based on the change or request you need to make to your account.

• Patient Accounting
• Utilization Management Service and Coverage

Patient Accounting

Phone:
650-812-3838

Monday through Friday, 9 a.m. to 5 p.m.

Available 24 hours by dedicated fax: 650-812-3739

Services:

• Answer questions about charges, bills or statements from services provided and billed by PAMF providers
  
• Make changes to patient insurance information on the phone -- any insurance type
  
• Make changes to patient demographics
  
• Accept payments from patients on their charges billed by PAMF providers

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Utilization Management Service and Coverage

Managed Care Ensures Appropriate Utilization Management Service and Coverage

In accordance with National Committee on Quality Assurance (NCQA) standards:

• Palo Alto Medical Foundation (PAMF) employees and Palo Alto Foundation Medical Group (PAFMG) physicians who make utilization related decisions, and those who supervise them, ensure decisions are based only on appropriateness of care and service and existence of coverage. Economic profiling is not used.  
  
• PAFMG does not specifically reward practitioners or other individuals conducting utilization review for issuing denials of coverage or service or encourage decisions that result in underutilization.
  
• Compensation plans for individuals who provide utilization review services do not contain direct or indirect incentives, financial or other, for these individuals to make inappropriate review decisions.
  
• Members have the right to independent, external review of final determinations.
  
• Members or their legal guardians may designate, in writing, a representative to act on their behalf.
  
• Members, practitioners and the public have the right to request clinical criteria, including requests for emerging and current technologies, devices, medical procedures, and techniques, or to discuss denial decisions and/or UM issues with appropriate practitioners.

Members, practitioners, employees and the public should direct all requests either in writing or by telephone to:

PAMF Managed Care Department
PO Box 50549
Palo Alto, CA 94303
408-523-3133 (you may call collect)

Last reviewed: June 2009
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