What is the difference between City of Hope National Medical Center and City of Hope Medical Foundation?
City of Hope National Medical Center and City of Hope Medical Foundation are both part of the City of Hope family. City of Hope National Medical Center is a California, non-profit hospital. City of Hope Medical Foundation is a non-profit organization which provides physician services to patients at City of Hope National Medical Center and at City of Hope community practices.
Why is the distinction between City of Hope National Medical Center and City of Hope Medical Foundation important to me?
City of Hope Medical Foundation bills for physician services provided at City of Hope’s community practices, the Medical Center and other area hospitals, while City of Hope National Medical Center only bills for hospital services rendered at the Medical Center.If you are insured by a HMO, and wish to receive treatment or services at City of Hope National Medical Center or from a City of Hope Medical Foundation physician, you must obtain an authorization from your health plan and/or medical group for both hospital services and physicians services. City of Hope National Medical Center will assist you in obtaining the appropriate authorizations for all services provided at the Medical Center. For any applicable co-payments, deductibles, or non-covered services, you may receive a bill from City of Hope National Medical Center and/or City of Hope Medical Foundation.
Which Health Plans are contracted with City of Hope?
City of Hope contracts with most major Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO) for hospital and physician services. For a list of plans with which each of City of Hope National Medical Center and City of Hope Medical Foundation contracts, view Is My Insurance Accepted?
In addition, City of Hope National Medical Center and Medical Foundation are participating providers in government programs such as Medicare and Medi-Cal.
Will insurance cover my care?
Insurance coverage will vary depending upon your insurance company, your plan, and the state in which you live. We recommend that you speak with a representative from your insurance company to ensure that your treatment is covered. Your insurance company can also tell you about any applicable co-payments or deductibles for which you will be responsible. You may also contact City of Hope Financial Support Services at 626-256-HOPE, Ext. 62715 for assistance. Since individual or group benefits vary, City of Hope cannot answer questions regarding your specific benefit coverage.
NOTE: If you belong to a HMO, your insurance will not pay for your health care services at City of Hope National Medical Center or from a City of Hope Medical Foundation physician unless you have an authorization. A written authorization, which gives you permission to be treated, must be obtained from your insurance company/medical group before each planned admission and each type of outpatient treatment, e.g. chemotherapy, ambulatory surgery, or diagnostic service.
How do I find a Primary Care Physician (PCP) that is contracted with both my insurance company and the City of Hope Medical Foundation?
Obtain a HMO Provider Directory booklet from your insurance company and search for a PCP in your area that is also listed with the City of Hope Medical Foundation (Is My Insurance Accepted?).
If I enroll with a Primary Care Physician (PCP) that contracts with City of Hope Medical Foundation, does that guarantee that my treatment at City of Hope National Medical Center will be authorized?
Not necessarily. Authorizations are granted based on various criteria, one of them being contractual relationships, but other more significant factors play a key role in this process. Typically, your independent practice association’s (IPA) Utilization Management/Case Management Departments, in conjunction with the PCP’s Medical Director, make decisions regarding authorizations.
Will City of Hope National Medical Center bill my insurance for hospital services?
Yes, City of Hope National Medical Center will bill your insurance company for your hospital services. However, you are financially responsible for any part of your medical bill that is not covered by your insurance. This includes your co-payments, deductibles and any non-covered services.
Will the City of Hope Medical Foundation bill my insurance for physician services?
Yes, City of Hope Medical Foundation will bill your insurance company for your physician services. However, you are financially responsible for any part of your medical bill that is not covered by your insurance. This includes your co-payments, deductibles and any non-covered services.
Can I still receive treatment at City of Hope National Medical Center or City of Hope Medical Foundation's community practices if my insurance plan is not accepted at City of Hope?
Contact your insurance company and ask about obtaining authorization to receive treatment at City of Hope. 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 with City of Hope directly. City of Hope can still provide treatment even if your plan will not authorize the treatment, or you do not have insurance. In these instances, a deposit is required prior to commencement of treatment.
Contact New Patient Services at 1-800-826-HOPE (4673) for more information.
My plan contracts with City of Hope, 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.dmhc.ca.gov or 1-888-HMO-2219 for further assistance.
Where can I find information relating to new technologies and therapies offered at City of Hope?
- The Latest News section is updated frequently and offers a quick glance at our most recent breaking news.
- Press releases are posted often, and provide detailed information about new therapies discoveries.
- View our on-line videos to learn about City of Hope’s newest therapies and treatments (including T-Cell Therapy, Islet Cell Transplantation, Laparoscopic Prostatectomy, and Telomerase Test Trials)
- Clinical Trials On-line has information about all clinical trials conducted at City of Hope. Subscribe to eHope for regular e-mail updates on City of Hope’s groundbreaking research and treatment for cancer, diabetes, and other life-threatening diseases.
