Effective 11/1/2009

Doyle Park Family Medicine
has joined
Sutter Medical Foundation North Bay

We are pleased to announce our new affiliation with Sutter. For most of you we anticipate this will be a seamless transition.

Unfortunately, there are some health plans that are not currently contracted with Sutter Medical Foundation North Bay. These plans are:

• Blue Cross Individual and Small Business HMO
• Blue Cross Select HMO (CalPERS)
• Blue Shield Sonoma Direct Network HMO (CalPERS)
• Cigna Gallo Access Plan and Cigna Voluntary Products
• Humana (unless through Interplan)
• Private Health Care Systems (PHCS) PPO

The Sutter insurance contracts are beyond our control. We regret that after 11/1/2009 your insurance will not pay for you to continue to receive care here if it is listed above. Many of you have been our patients for quite some time and we are sad that we must end our relationship at this time. It has been a privilege to take care of you. If you are unable to continue care with us, we will make your medical records available to your new physician upon your written request.

Health Insurance is very confusing, for you and for us. In general, there are two basic forms of health insurance (in addition to Medicare and MediCal): HMO and PPO.

PLEASE NOTE THAT DRS. SHAW AND CEDERBERG ARE NOT CURRENTLY ACCEPTING NEW PATIENTS

Insurance Accepted for New Patients

Doyle Park is currently accepting new patients with the following health plans:

All HMO plans contracted with Sutter Medical Group Of The Redwoods (your Card will have “Sutter Medical Group Of The Redwoods” on it).One of our physicians MUST be listed as your Primary Care Physician (PCP) for us to see you.

• Blue Shield
• Blue Cross
• Aetna
• Pacific Care
• Health Net
• Secure Horizons
• Health Net Seniority Plus

PPO plans do not have a doctor’s name or medical group on the card. We are currently accepting new patients with:

• Blue Shield
• Blue Cross
• Blue Cross/Blue Shield
• United Health Care
• Pacific Care
• Health Net
• Aetna
• Interplan (including P5, City of SR, County of Sonoma)
• Cigna
• Sutter Select

Plans For Which We Do *Not Accept New Patients

Unfortunately, we are not accepting new patients with the following plans:

• Blue Shield CALPERS HMO ( it says ‘Calpers’ on the card)
• Medicare, including Medicare with supplementary insurance
• MediCal
• CMSP

Current Doyle Park patients with Medicare or MediCal are welcome to continue receiving care with us.

We do not offer care for work-related (Worker’s Compensation) injuries.

Other Insurance Plans

If your insurance is not one of those listed above, please send us an e-mail or call us to find out whether we’re contracted with your insurer.

Expenses You Are Responsible For

Most insurance companies require that you pay a copayment for each office visit, due at the time you check in at the office. You will be charged an Administration Fee if you require us to bill you for your co-pay. Remaining charges (once your deductible is met) are billed to your insurance carrier.

Some services we provide may not be covered by your insurer. You are responsible for any services not covered by your policy.