Members
The California Foundation for Medical Care (CFMC) is a Preferred Provider Organization (PPO)
committed to providing a high quality Network with great customer service. We offer members statewide access to providers so you can choose the appropriate care based on your individual needs.
By selecting a network provider your out-of pocket cost will be less and the provider will submit claims for you.
What You Need To Know
Locate a PPO Provider via this website by selecting the Provider Search Button and follow the prompts.
Or call us at 800-334-7341 to speak to a customer service representative who can assist you in locating a provider.
Call the provider to schedule an appointment and inform them that your health plan has selected the California Foundation for Medical Care (CFMC) Network as their preferred network.
Your Health ID card displays the CFMC logo and identifies your access to the CFMC PPO Network. Present the Health ID card to your provider of service. The ID card will also have your Plan Administrators telephone number to verify your eligibility, obtain benefits and any pre-certification required by your plan.
Become familiar with your health plan coverage and any pre-certifications required by your health plan.
Verify that services recommended by a network provider are covered by your health plan. For example anesthesiology, pathology or radiology rendered in a network facility may not be in-network.
You will receive an Explanation of Benefits (EOB) reflecting the CFMC discount applied to your claim and any amounts you may be responsible for, such as co-payments, co-insurance, deductibles or non covered expenses. Providers may not bill you for the difference between billed and discounted charges.
Please Note:
CFMC is the PPO Network only and does not pay claims, verify eligibility or benefits. Please contact your insurance company or health plan administrator for assistance at the telephone number listed on your Health ID card.