Billing Info

Notice of Privacy Practices - English

Notice of Privacy Practices - Spanish


1. Can I still receive treatment from City of Hope Medical Group if my insurance plan is not accepted at City of Hope Medical Group or another partner hospital?
Contact your insurance company and ask about obtaining authorization to receive treatment. Every medical situation - and every insurance plan - is different, and there is no guarantee that coverage can be secured. But it is reasonable to make this request, and to ask your insurance company to review the matter. City of Hope Medical Group can still provide treatment even if your plan will not authorize the treatment, or if you do not have insurance. In these instances, a deposit is required prior to commencement of treatment and you would be responsible for the payment related to services your doctor renders.

2. My plan contracts with City of Hope Medical Group, but has denied coverage for a particular medical stay or procedure. What can I do?
Please refer to the back of your insurance card and call the applicable Customer Service or Member Services Department and inquire about your appeal rights. You may also refer to the California Department of Managed Health Care at www.dmc.ca.gov or 1-888-HMO-2219 for further assistance.

3. Will I be expected to pay for a portion of my medical care?
The City of Hope Medical Group contracts with a significant number of health plans, medical groups and IPA's; however, we do not have relationships with everyone. At times, there are also changes to our contracted relationships that may affect your financial responsibility. Prior to receiving services at City of Hope Medical Group, it is important that you determine if City of Hope Medical Group is contracted with your insurer. You should contact your insurer directly to obtain this information and to understand your financial responsibility in the event your insurer is not contracted with us. In such a case, you may be directly responsible for payment of your medical bills with City of Hope Medical Group.

Depending on your health care coverage you may have several options with respect to how you may access the City of Hope Medical Group. It is important to understand that you may be financial responsible for a portion or all of medical care, depending on your insurance coverage.

In general, members are enrolled under one of the following plans:

Health Maintenance Organization (HMO): Health care services under HMO plans are managed by your primary care provider (PCP) in the form of a "referral" or "authorization." Generally, the process begins with your PCP, who would submit a referral request to the group's/IPA's medical director or other medical review body who has clinical background and expertise. This individual is responsible for substantiating the need to seek health care services from an outside specialist such as City of Hope Medical Group. The various components that may be considered before a referral is granted are the following:

  • Diagnosis, disease stage, treatment history and prognosis
  • Location of the specialty group in proximity to the region in which you live
  • Existence of a financial relationship between your PCP and the specialty group

If you are enrolled under an HMO plan and are interested in the City of Hope Medical Group, you should discuss your options with your physician.

Preferred Provider Organization (PPO): If you are a PPO subscriber, you may have a wider selection of providers from which to choose. In most cases, you are not obligated to obtain a referral/authorization. However, it is imperative that you verify with your insurance company whether or not the City of Hope Medical Group actively participates in their PPO network.

Point-of-Service (POS): A POS plan is a combination of both HMO and PPO options. You may elect to access services via your primary care provider, however you also have the ability to "opt-out" and self-refer to the provider of your choice using your PPO benefit.