How Medical Groups Work with Plans

Medical groups/IPAs contract with health plans and take responsibility for the care of their members. On behalf of health plans, medical groups make sure these members have access to what they need to stay healthy and well. This includes doctors, hospitals, urgent care centers, and health programs and resources.

At Hill Physicians, we have teams that work alongside our doctors to help our members at every stage of their healthcare journey. In addition to supporting our doctors as they care for our members, we also:

Hill Physicians contracts with most Health Plans in Northern California to provide HMO patients a network of physicians to which they can receive care. Our HMO members become a part of Hill Physicians when they select a primary care physician (PCP) within our network and designate Hill Physicians as their medical group. Hill Physicians processes claims, referrals, and authorizations for our members when they see physicians within our network. Members have access to top academic and community hospitals and urgent care centers that are contracted with Hill Physicians.

Hill Physicians contracts with select PPO plans to provide care management services for patients. These services include case management and care coordination. PPO patients could become Hill Physicians members when they select one of our primary care physicians during open enrollment or when they see one of our primary care physicians for the majority of their care. PPO patients that designate a primary care doctor still have the flexibility to see any doctor they choose.