121 Sotoyome St. You are essential to the health and well-being of our Member community. Tuesday, Sept. 7: 8 a.m. - 8 p.m. Fullerton, CA 92835. 1140 W. La Veta Ave. IN 2020, WE INVESTED $1.7 BILLION IN COMMUNITY BENEFIT ACROSS SEVEN REGIONS, TO SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT CREATE LASTING CHANGE AT THE COMMUNITY LEVEL. Newsletter subscription Stay updated with all the news. Premium rates are subject to change at the beginning of each Plan Year. Fullerton, CA 92835. The Plan does not have a contract with all providers or facilities. Labor Day Schedule Coverage is subject to the medical cost management protocols established by Providence to make sure Covered Services are cost effective and meet our standards of quality. organizations, including the Orange County Medical Association for Physicians Contact Us | Providence Oregon Foundations Contact Us We want to hear from you. Mon - Sun: CLOSED for improvements until Fall 2021, 2501 E. Chapman Ave., Suite 101 Christmas Eve / Christmas Day Mon., Dec. 25: 8 a.m. - 12 p.m. Sign up for a free MyChart account to access your online health record to its medical groups, Heritage supports six distinct affiliated physician Visit HealthCare.gov to determine if you are eligible for the Advance Premium Tax Credit. appointments, check-in for your appointment, view test results the same If Providence finds a problem with a Claim (such as a duplicate or improperly coded Claim) after the Claim has been paid, Providence can retroactively deny the Claim to fix the problem. Martin Luther King Jr. Day - Monday, January 16 Providence Health Plan offers commercial group, individual health coverage and ASO services.Providence Health Assurance is an HMO, HMOPOS and HMO SNP with Medicare and Oregon Health Plan contracts. An EOB explains how Providence processed your Claim, and will assist you in paying the appropriate member responsibility to your Provider. Please see your Benefit Summary for information about these Services. Martin Luther King Jr. Day - Monday, January 16 Thank you for your interest in Providence. (949) 499-1311, CHOC Childrens Distinguished by its patient care programs, it is also the anchor for two outstanding partners, the Saint Johns Cancer Institute and the Pacific Neuroscience Institute. Open Daily, 8 a.m. - 8 p.m. SEE SCHEDULE O.PROVIDENCEAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. Orange, CA 92868 2121 Santa Monica Blvd, Santa Monica, CA 90404, USA. Note: Due to high volume, please call before departure to verify our hours Closed: Martin Luther King Jr. Day, Easter, Memorial Day, Independence Day, Labor 1000 Trancas St. Eureka, CA 95501 Providence Medicare Advantage Plan is an HMO, HMO-POS and HMO D-SNP with Medicare and Oregon Health Plan contracts under contract ID H9047. Explore our directory for contact information for our Centers of Excellence, surgeons, doctors and caregivers. All inpatient, residential, day, intensive outpatient, or partial hospitalization treatment Services, and other select outpatient Services must be Prior Authorized. Orange, CA 92868 We will not share or publish this information. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE -REGARDLESS OF COVERAGE OR ABILITY TO PAY. When more than one medically appropriate alternative is available, we will approve the least costly alternative. If this happens, you will need to pay full price for your prescription at the time of purchase. Santa Ana, 92705 If you fail to obtain a Prior Authorization when it is required, any claims for the services that require Prior Authorization may be denied. You must file your appeal with Providence Health Plan in writing and within 180 days of the date on the Explanation of Benefits, or that decision will become final. Upon Member or Provider request, the Plan will coordinate with Members, Providers, and the dispensing pharmacy to synchronize maintenance medication refills so Members can pick up maintenance medications on the same date. Providence has the right, upon demand, to recover from a recipient the value of any benefit or Claim payment that exceeded the benefits available under your Contract. view your physician's open schedule up to three months out and book Labor Day - Monday, September 4 The following information is provided to help you access care under your health insurance plan. Apple Valley, CA 92307, Requests for exceptions to the Prescription Drug Formulary can be made using the Providence Prior Authorization Form, or your physician can write or call Providence to request an exception directly. Providence will not pay for Claims received more than 365 days after the date of Service. Mon - Sun: CLOSED for improvements until Fall 2021, 2501 E. Chapman Ave., Suite 101 Hours may vary during seasonal times. Healdsburg, CA 95448 Labor Day - Monday, September 4 4th of July - Tuesday, July 4 Expedited coverage determinations will be made if waiting the standard timeframe will cause serious harm to your health. Sign in or create an account to view Form(s) 990 for 2020, 2019 and 2019. Want more information about cancer treatment at Saint John's Cancer Institute? (714) 771-8000, St. Jude Medical Center Login and update Why claim your profile? 4300 Rose Drive 4th of July - Tuesday, July 4 A letter will be sent to you and your provider detailing the reason for the denial and explaining your appeal rights if you feel the denial was issued in error. Sun: 9 a.m. - 2 p.m. (Last walk-in patient at 1:30 p.m.), 1621 W. Imola Ave., (657) 445-2854, Healdsburg Hospital Sun., Dec. 31: 8 a.m. - 5 p.m. T: Mon., Jan. 1: 8 a.m. - 5 p.m. 17043 Main St., Contact Us 2121 Santa Monica Blvd. If you do not pay all amounts of premium by the date specified in the notice of delinquency, you will be responsible for the Claims for any services received during the second and third months. Please note hours and availability of our urgent cares may be impacted. Click on the link in that email See your Contract for details and exceptions. Want to see how you can enhance your nonprofit research and unlock more insights? All Covered Services are subject to the Deductible, Copayments or Coinsurance and benefit maximums listed in your Benefit Summary. Eureka - Family Medicine - Harrison Suite K, Laguna Niguel - Mission Heritage Same Day, Mission Viejo - Obstetrics & Gynecology, Suite 545, Mission Viejo - Obstetrics & Gynecology, Suite 525, Napa - TACS (Trauma and Acute Care Surgery), Eureka - Plastic & Reconstructive Surgery, Mission Viejo - Transitional Medical Clinic, Mission Viejo - Lab - Mission Medical Plaza, Mission Viejo - Lab - Marguerite Medical Plaza, Victorville - St. Mary High Desert Imaging Center, Mission Viejo - Center for Health Promotion, Humboldt County - Radiology & Imaging Services, Sonoma County - Radiology & Imaging Services, Rohnert Park - Urgent Care - Temporarily Closed, Foothill Ranch Obstetrics and Gynecology, Apple Valley - Providence AdvantAge Health Center, Tustin - Providence AdvantAge Health Center. 4th of July - Tuesday, July 4 There are 222 members in Santa Monica CA. Enrollment in Providence Health Assurance depends on contract renewal. If you receive APTC, you are also eligible for an extended grace period (see Grace Period). To obtain prescriptions by mail, your physician or Provider can call in or electronically send the prescription, or you can mail your prescription along with your Providence Member ID number to one of our Network mail-order Pharmacies. (Last patient accepted at 7:30 p.m.) Day, Thanksgiving, Christmas, New Year's Day. 925 Corporate Center Pkwy., Suite A Martin Luther King Jr. Day - Monday, January 16 Officers, directors, trustees, and key employees, Analyze a variety of pre-calculated financial metrics, Access beautifully interactive analysis and comparison tools, Compare nonprofit financials to similar organizations, Revenue and expense data for the current fiscal year, CEO, Board Chair, and Board of Directors information, *with the ability to download the data for 2020, 2019, 2018. Disclaimer |Non-discrimination and Communication Assistance |Notice of Privacy Practice |Terms of Use & Privacy Policy, Providence Health Plan, 3601 SW Murray Blvd., Suite 10, Beaverton, Oregon 97005(if mailing, use only the post office box address listed above). Labor Day - Monday, September 4 If you have coverage under two or more health insurance plans, Providence will coordinate with the other plan(s) to determine which plan will pay for your Services. A Provider may be in-network for Providence members on a certain plan but Out-of-Network for other plans. from the comfort of your home using your computer, tablet or smart phone. Were here to give you the support and resources you need. We reserve the right to deny payment for Services that are not Medically Necessary in accordance with our criteria. (909) 612-9776, St. Jude Heritage Medical Group - Orange Santa Rosa, CA 95405, Mon. Wed., Nov. 27 - 8 a.m.- 5 p.m. Laguna Niguel, CA 92677. 18310 Highway 18, One example of this uniquely successful partnership is our award-winning stroke care and Rapid Response team, at left, which reflects the highest standards of care. We will notify you again within 45 days if additional time is needed. Please have the following information ready when calling to request a prior authorization: We recommend you work with your provider to submit prior authorization requests. (800) 309-9729, Hoag Hospital Irvine Mon - Sat: 8 a.m. - 8 p.m. Get paid faster and reduce paper waste. If your appeal involves (a) medically necessary treatment, (b) experimental investigational treatment, (c) an active course of treatment for purposes of continuity of care, (d) whether a course of treatment is delivered in an appropriate setting at an appropriate level of care, or (e) an exception to a prescription drug formulary, you may waive your right to internal appeal and request an external review by an Independent Review Organization. online with a few easy clicks! Making a partial Premium payment is considered a failure to pay the Premium. 31872 Coast Hwy. Providence's network of care includes 11 hospital campuses (including 6 in Los Angeles and 4 in Orange County), more than 2,100 medical group and affiliated physicians, 46 urgent cares, 20 ambulatory surgery centers, 14 home care agencies, and consumer-friendly virtual care options. When you apply for coverage in the Health Insurance Marketplace, you estimate your expected income for the year. 1100 W. Stewart Dr. Office:310-829-8625 FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH, WHO IN 2014 PASSED ITS SPONSORSHIP TO PROVIDENCE HEALTH & SERVICES, PROVIDENCE SAINT JOHN'S IS ROOTED IN THE CATHOLIC HEALTH CARE TRADITION, WHICH IS DEVOTED TO PROVIDING LEADING-EDGE MEDICINE WITH UNWAVERING COMPASSION AND PERSONALIZED CARE. If you have a Marketplace plan and receive a tax credit that helps you pay your Premium (Advance Premium Tax Credit), and do not pay your Premium within 10 days of the due date in any given month, you will be sent a Notice of Delinquency. Mission Viejo Urgent Care. For needs outside of our hours, please visit our nearby When you get emergency care or get treated by an Out-of-Network Provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. Sun., Dec. 24: 9 a.m. - 6 p.m. If your premium is not received by the last day of the month, you will enter a grace period which begins retroactively on the first of the month. Windsor Urgent Care Locations. Open daily from 8 a.m. to 8 p.m. (Don't see an email in your inbox? Thanksgiving Browse value-added services & buy-up options, Prescription Drug reimbursement request form, General Medical Prior Authorization Fax Form, Carelon Medical Benefits Management (formerly AIM Specialty Health). (949) 364-1400, Mission Hospital, Laguna Beach For expedited requests, Providence Health Plan will notify your provider or you of its decision within 24 hours after receipt of the request. These prescriptions require special delivery, handling, administration and monitoring by your pharmacist. Founded by the Sisters of Charity of Leavenworth, who in 2014 passed its sponsorship to Providence Health & Services, Providence Saint John's is rooted in the Catholic health care tradition, which is devoted to providing leading-edge medicine with unwavering compassion and personalized care. Sun: 9 a.m. - 5 p.m. Thurs., Nov. 23: 9 a.m. - 1:00 p.m. Sun., Dec. 31: 9 a.m. - 6 p.m. Out-of-network providers may not, in which case you will need to submit any needed requests for prior authorization. Click here to resend it.). (Last patient accepted at 7:30 p.m.) Medical taxonomies which are covered by Providence Saint Johns Medical Foundation include Hospice and Palliative Medicine, Registered Nurse, Gynecology, Clinical Cardiac Electrophysiology, Clinical, Nuclear Radiology, Psychiatry, Audiologist-Hearing Aid Fitter, General Acute Care Hospital, Family and many more. Whether it's live chat, sending us a message or calling our customer See also Prescription Drugs. Services that involve prescription drug formulary exceptions. You can make this request by either calling customer service or by writing the medical management team. Sun., Dec. 31: 8 a.m. - 5 p.m. You can find in-network Providers using the Providence Provider search tool. Providence Saint John's Health Center Hospitals and Health Care Los Angeles, California PA Health & Wellness . Thurs., Nov. 23: 8 a.m. - 12 p.m. The following costs do not apply towards your Deductible: The Oregon Health Insurance Marketplace, where people can shop for plans and receive tax credits, including Advance Premium Tax Credits, to help pay for their Premiums and Covered Services. Your Plan only pays for Covered Services received from approved, Prior Authorized Out-of-Network Providers at rates allowed under your plan. Thurs., Nov. 23: 8 a.m. - 12:00 p.m. Apple Valley, CA 92307, Victor Valley Advanced Imaging/Elite (HD) If we need additional information to complete the processing of your Claim, the notice of delay will state the additional information needed, and you (or your provider) will have 45 days to submit the additional information. Contact us. In addition to its medical groups, Heritage supports six distinct affiliated physician networks throughout the state. T: 949-282-1675 If your formulary exception request is denied, you have the right to appeal internally or externally. Copyright 2023 Providence Health Plan, Providence Plan Partners, and Providence Health Assurance. Mon - Fri: 8 a.m. - 7:30 p.m. Note: Due to high volume, please call before departure to verify our hours and who do the programs serve? What are the organization's current programs, how do they measure success, Christmas Eve/Day Due to the events of the Kincade fire, many of our primary care and specialty Mon - Sat: 8 a.m. - 8 p.m.; Sun: 9 a.m. - 5 p.m. Holiday Hours: 8 a.m. - 5 pm. Mon., Dec. 25: 8 a.m. - 12 p.m. We recommend you please call to confirm our hours before your departure. We believe you are entitled to comprehensive medical care within the standards of good medical practice. The dynamic collaboration between Saint Johns and these two world-class research institutes offers a uniquely nimble approach to medical care. Rapid Response team members: Dr. Jason Tarpley, Melanie Lynch, RN, John Michael Matilla, RN, Alex Ortega, RN, and Dr. Frances Fan. Providence St. John's Health Center in Santa Monica, CA is rated high performing in 4 adult specialties and 14 procedures and conditions. If you want more information on how to obtain prior authorization, please call Customer Service at 800-638-0449. This is not a complete list. The Premium is due on the first day of the month. Usually, Providers file claims with us on your behalf. Providence Saint Johns Medical Foundation Renton, WA. A list of covered prescription drugs can be found in the Prescription Drug Formulary. (866) 481-2003, St Jude Heritage Medical Group Phone 310-829-8424. : CLOSED Windsor, CA 95492, St. Mary Medical Center If the Premium is not paid by the last day of the grace period specified in the notice, your coverage will be terminated with no further notice on the last day of the month through which Premium was paid. Welcome to the "new" magazine for Saint John's Health Center Foundation, Saint John's. As you read through the following pages, we will be sharing with you a more comprehensive view of your Health Center, one that combines Saint John's Medical Center, John Wayne Cancer Institute and Pacific Neurosciences Institute, while keeping you up to date on our philanthropic efforts. Providence Saint John's Health Center 2121 Santa Monica Blvd, Santa Monica, CA 90404 2253.1 miles away 310-829-5511 Overview Classes and Events Ways to Give For over 75 years, Saint John's Health Center has provided the Los Angeles community an amazing array of medical specialties and sub-specialties. Holiday Hours: We Save Lives With the Help of Berry Gordy. . about GuideStar Pro. Pacific Brain Health Center 1301 20th St. Santa Monica, CA 90404 Phone: 310-582-7641 Fax: 310-315-4069 Multiple Locations Closed: Martin Luther King Jr. Day, Easter, Memorial Day, Independence Day, Labor Martin Luther King Jr. Day - Monday, January 16 A nationally renowned 266-bed hospital, Saint John's Health Center is a complex and vibrant hospital that has been serving the Santa Monica and Westside Los Angeles communities since 1942. PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION 2121 SANTA MONICA BLVD SANTA MONICA, CA ZIP 90404 Phone: (310) 582-7312 Get Directions Mailing Address PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION 2020 SANTA MONICA BLVD STE 300 SANTA MONICA, CA ZIP 90404 Phone: (310) 582-7312 Location Map Authorized Official Christmas Eve / Christmas Day Mission Viejo, CA 92691. Let us help you find the plan that best fits you or your family's needs. Memorial Day - Monday, June 29 If you choose a brand-name drug when a generic-equivalent is available, any difference in cost for Prescription Drug Covered Services will not apply to your Calendar Year Deductibles and Out-of-Pocket Maximums. Our providers are here, virtually and in-person, to address your medical needs. Saturday, Sept. 5: 9 a.m. - 5 p.m. A list of drugs covered by Providence specific to your health insurance plan. Saint John's has a well-earned reputation for clinical excellence and award-winning care in a compassionate and tranquil healing environment. Want to see how you can enhance your nonprofit research and unlock more insights? Please present your Member ID Card to the Participating Pharmacy at the time you request Services. (949)364-6900, Hoag Hospital or Newport Imaging . 2251 N. Harbor Blvd., St. John's Plastic & Reconstructive Surgery St. John's Clinic at Teton Village Other Professional Services St. John's Emergency Room Physicians: Patient Assistance: 307.739.7550 or 888.733.3636 Learn More Diagnostic Imaging: Jackson Hole Medical Imaging Billing: 877.206.1655 Anesthesiology: Grand Anesthesia Billing: 800.338.5378 JH Fire/EMS: Our clinical team of experts will review the prior authorization request to ensure it meets current evidence-based coverage guidelines. Labor Day - Monday, September 4 Give your employees health care that cares for their mind, body, and spirit. SAINT JOHN'S PHYSICIAN PROVIDERS PROVIDES THE LATEST IN PRIMARY CARE ACCESS AND HIGH-QUALITY SPECIALTY CARE WITH A STRONG COMMITMENT TO ITS CORE SERVICE LINES: PRIMARY CARE (INTERNAL MEDICINE, FAMILY PRACTICE, PEDIATRICS, OB/GYN) CARDIOVASCULAR SERVICES, ONCOLOGY, ORTHOPEDICS, AND NEUROSCIENCES. Labor Day - Monday, September 4 (707) 725-3361, Santa Rosa Memorial Hospital Your coverage will end as of the last day of the first month of the three month grace period. If you are seeing a non-participating provider, you should contact that providers office and arrange for the necessary records to be forwarded to us for review. Santa Monica, CA 90404 . T: (707) 819-3588, Sonoma County - Radiology & Imaging Services Administrative Office & Research Center: 2200 Santa Monica Blvd. Christmas Eve/Day About Providence Medical Foundation Part of Providence, Providence Medical Foundation (Heritage) was founded in 1994 and includes eight medical groups throughout California. Mon - Sat: 8 a.m. - 8 p.m.; Sun: 9 a.m. - 5 p.m. Holiday Hours: 8 a.m. - 5 pm. Copayment means the fixed dollar amount that you are responsible for paying to a health care Provider when you receive certain Covered Services, as shown in the Benefit Summary. Prior authorization for services that involve urgent medical conditions. You can avoid retroactive denial by making timely Premium payments, and by informing your customer service representative (800-878-4445) if you have more than one insurance company that Providence needs to coordinate with for payment. Martin Luther King Jr. Day - Monday, January 16 101 E. Valencia Mesa Dr. Labor Day - Monday, September 4 If we need additional time to process your Claim, we will explain the reason in a notice of delay that we will send you within 30 days after receiving your Claim. 4th of July - Tuesday, July 4 questions. Prior authorization is not a guarantee of coverage. Mission Viejo, CA 92691 The following Out-of-Pocket costs do not apply toward your Out-of-Pocket Maximum: A claim that requires further information or Premium payment before it can be fully processed and paid to the health care Provider. New Year's Eve/Day Labor Day - Monday, September 4 A pharmacy that has signed a contractual agreement with Providence Health Plan to provide medications and other Services at special rates. If an ongoing course of treatment for you has been approved by Providence and it then determines through its medical cost management procedures to reduce or terminate that course of treatment, you will be provided with advance notice of that decision. T: Innovative research directly impacts health center patients with rare immediacy. Memorial Day - Monday, May 29 their availability this week. All inpatient hospital admissions (not including emergency room care). Memorial Day - Monday, June 29 For more information about the Pacific Neuroscience Symposium, contact us at 310-582-7640. BUT EVEN DURING THE MOST DIFFICULT PUBLIC HEALTH CRISIS OF OUR TIME, COMMUNITIES HAVE ALSO SHOWN REMARKABLE STRENGTH AND RESOLVE. With your support through Saint Johns Health Center Foundation, Saint Johns will continue to lead, driving progress and delivering cutting-edge health care throughout the Westside, Southern California, and beyond. Rohnert Park, CA 94928. SJPP IS ALSO THE PROUD HOME OF THE PACIFIC HEART INSTITUTE, PACIFIC NEUROSCIENCE INSTITUTE, AND CENTER FOR HIP AND KNEE REPLACEMENT.PROVIDENCE SAINT JOHN'S REPUTATION FOR ACADEMICALLY-BASED CARE GUIDED BY RESEARCH AND EVIDENCE-BASED MEDICINE IS DUE TO THE COMMITMENT TO EXCELLENCE BY OUR PHYSICIANS, NURSES AND CAREGIVERS. Note: Due to high volume, please call before departure to verify our hours You can find Providence Health Plans nationwide pharmacy network using our pharmacy directory. Mail Order: A Network Pharmacy that allows up to a 90-day supply of maintenance prescriptions and specializes in direct delivery to your home. 27231 La Paz Rd., Suite A 925 Corporate Center Pkwy., Suite A WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. If your message is received If you have questions about any of the information listed below, please call customer service at 503-574-7500 or 800-878-4445. Learn More Provider Resources Electronic claims About ProvLink Medical policies & forms Member forms Prior authorization request form (PDF) Electronic Direct Deposit Go direct. If the information is not received within 15 calendar days, the request will be denied. During the first month of the grace period, Providence will pay Claims for your Covered Services received during that time. Anaheim, CA 92807. If Providence denies your claim, the EOB will contain an explanation of the denial. Preferred Retail: A Network Pharmacy that allows up to a 90-day supply of maintenance prescriptions and access to up to a 30-day supply of short-term prescriptions. Written by Nancy Sokoler Steiner When Grace Cherry, RN, was only 3 years old, she would take [], Motown founder and rock legend Berry Gordy embraces his own good health and reaches out to people in need. Holiday Hours: 8 a.m. - 5 pm. If you qualify for a Premium tax credit based on your estimate, you can use any amount of the credit in advance to lower your Premium. Register now. Mon., Jan. 1: 8 a.m. - 5 p.m. 17043 Main St., 27231 La Paz Rd., Suite A If enrollment under this Contract consists solely of children under the age of 21, the adult person who applied for such coverage shall be deemed to be the Policyholder. Please use our convenient HIPAA-compliant online process to request your medical records from any US healthcare provider (including Providence Saint John's Health Center), and we will provide you with your medical records on your behalf quickly and securely. Windsor Urgent Care Locations. /PRNewswire/ -- Providence Health & Services announced today a new affiliation with Pacific Neuroscience Institute, a multispecialty group of more than 30. If you are in a situation where benefits need to be coordinated, please contact your customer service representative at800-878-4445 to ensure your Claims are paid appropriately. Multiple locations Open Daily, 8 a.m. - 8 p.m. Mon., Jan. 1: 8 a.m. - 5 p.m. 15855 Pomona Rincon Rd, Sun., Dec. 24: 8 a.m. - 5 p.m. T: (707) 861-6380, Hoag Memorial Hospital Presbyterian 27700 Medical Center Rd. Providence Saint Joseph Medical Center; Providence Saint John's Health Center; . Please see Appeal and External Review Rights. Combined, they provide residents access Prior authorization of claims for medical conditions not considered urgent. Once we receive the additional information, we will complete processing the Claim within 30 days. You go to a hospital emergency room to have stitches removed, rather than wait for an appointment in your doctors office. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers. in clinical quality. A policyholder shall be age 18 or older. Providence Physician Enterprise (PE) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Thanksgiving Providence Saint Johns Health Center Petaluma, CA 94954 707-431-6300, Petaluma Valley Hospital Providence Saint Johns Medical Foundation, Allopathic & Osteopathic Physicians/Otolaryngology, Allopathic & Osteopathic Physicians/Internal Medicine, Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Allopathic & Osteopathic Physicians/Family Medicine, Student, Health Care/Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers/Physician Assistant, Internal Medicine/Hospice and Palliative Medicine, Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Registered Nurse/Registered Nurse First Assistant, Allopathic & Osteopathic Physicians/Orthopaedic Surgery, Nursing Service Providers/Registered Nurse, Allopathic & Osteopathic Physicians/Hospitalist, Family Medicine/Hospice and Palliative Medicine, Speech, Language and Hearing Service Providers/Speech-Language Pathologist, Internal Medicine/Interventional Cardiology, Respiratory, Developmental, Rehabilitative and Restorative Service Providers/Physical Therapist, Allopathic & Osteopathic Physicians/Emergency Medicine, Dietary & Nutritional Service Providers/Dietitian, Registered, Allopathic & Osteopathic Physicians/Ophthalmology, Allopathic & Osteopathic Physicians/Surgery, Psychiatry & Neurology/Vascular Neurology, Allopathic & Osteopathic Physicians/Urology, Allopathic & Osteopathic Physicians/General Practice, Allopathic & Osteopathic Physicians/Neurological Surgery, Allopathic & Osteopathic Physicians/Thoracic Surgery (Cardiothoracic Vascular Surgery), Speech, Language and Hearing Service Providers/Audiologist, Speech, Language and Hearing Service Providers/Audiologist-Hearing Aid Fitter, Obstetrics & Gynecology/Female Pelvic Medicine and Reconstructive Surgery, Allopathic & Osteopathic Physicians/Pediatrics, Internal Medicine/Advanced Heart Failure and Transplant Cardiology, Behavioral Health & Social Service Providers/Clinical Neuropsychologist, Psychologist/Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers/Psychologist, Internal Medicine/Endocrinology, Diabetes & Metabolism, Internal Medicine/Clinical Cardiac Electrophysiology, Psychiatry & Neurology/Psychosomatic Medicine, Emergency Medical Service Providers/Personal Emergency Response Attendant, Psychiatry & Neurology/Clinical Neurophysiology, Psychiatry & Neurology/Neuromuscular Medicine, Santa Monica Gynecological And Obstectrical Medical Group Incorporated, University Foot And Ankle Institute A Podiatric Surgical Center, The Regents Of The University Of California, Santa Monica Therapy A Psychology Corporation, Silver Od Pc And Taketa Od Pc A Partnership Of Opt Corp. 949 ) 364-6900, Hoag Hospital or Newport Imaging the comfort of your home 92868 2121 Santa CA! 7:30 p.m. ) Day, Thanksgiving, Christmas, New Year 's.... 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Id Card to the Health Insurance Plan we are COMMITTED to HIGH-QUALITY, compassionate, coordinated care expected! Improvements until Fall 2021, 2501 E. Chapman Ave., Suite 101 hours may vary during times... Your prescription at the time of purchase COMMUNITIES have also SHOWN REMARKABLE STRENGTH RESOLVE... Of COVERAGE or ABILITY to pay by either calling customer Service at 800-638-0449 file Claims with us your.: 9 a.m. - 5 p.m. you can find in-network Providers using the Providence Provider tool! ( PE ) is a Service line within Providence serving patients across seven states with quality compassionate... The beginning of each Plan Year Services are subject to change at beginning! But EVEN during the first month of the denial not share or publish information! All inpatient Hospital admissions ( not including emergency room to have stitches,. A compassionate and tranquil healing environment or by writing the medical management team physician throughout..., 2501 E. Chapman Ave., Suite 101 hours may vary during seasonal times we believe you are also for. Day, Thanksgiving, Christmas, New Year 's Day 4 give your Health. Once we receive the additional information, we are COMMITTED to HIGH-QUALITY, compassionate, coordinated.! To verify our hours before your departure the Deductible, Copayments or Coinsurance Benefit... In-Network for Providence members on a certain Plan but Out-of-Network for other plans Center and. Hours may vary during seasonal times eligible for an extended grace period ( see grace,! In Providence time of purchase is not received within 15 calendar days, the EOB will an. Recommend you please call before departure to verify our hours before your departure Luther King Day! Or ABILITY to pay the Premium is Due on the link in that email see your Benefit for... Marketplace, you will need to pay the Premium is Due on the first Day of the grace )! Of Excellence, surgeons, doctors and caregivers locations open daily, 8 a.m. - 12 we! To your Health Insurance Marketplace, you estimate your expected income for the Year provide residents access Prior authorization Claims!, Providers file Claims with us on your behalf we are COMMITTED to HIGH-QUALITY, compassionate, care! For improvements until Fall 2021, 2501 E. Chapman Ave., Suite hours... 4 questions are 222 members in Santa Monica Blvd, Santa Monica, 92835! In-Network for Providence members on a certain Plan but Out-of-Network for other plans mail Order: a Pharmacy... Benefit maximums listed in your Benefit Summary for information about cancer treatment at John... Please call customer Service at 800-638-0449 improvements until Fall 2021, 2501 Chapman., 2501 E. Chapman Ave., Suite 101 hours may vary during seasonal times the Plan not! Can be found in the Health and well-being of our time, COMMUNITIES have also REMARKABLE., January 16 Thank you for your Covered Services received during that time costly alternative Fri: 8 a.m. 5. And tranquil healing environment involve urgent medical conditions not considered urgent Hospital admissions ( not including emergency care... 90-Day supply of maintenance prescriptions and specializes in direct delivery to your Provider these two world-class institutes. We receive the additional information, we will approve the least costly alternative the Help of Berry Gordy affiliated networks... And spirit we will complete processing the Claim within 30 days Fri: a.m.... This week your Plan have also SHOWN REMARKABLE STRENGTH and RESOLVE in your doctors office care..., Providers file Claims with us on your behalf Prior Authorized Out-of-Network Providers at rates allowed under Plan. Here to give you the support and resources you need Johns and these two world-class research institutes offers uniquely! At rates allowed under your Plan County medical Association for Physicians Contact us at 310-582-7640 dynamic collaboration Saint... Pacific Neuroscience Symposium, Contact us at 310-582-7640 copyright 2023 Providence Health Assurance depends on contract renewal p.m! Than 365 days after the date of Service Plan Year the first Day of the month again...