Providers: Provider Resources: Authorizations
Authorizations
Authorizations are based on medical necessity and covered services. Authorizations are contingent upon member’s eligibility and are not a guarantee of payment. The provider is responsible for verifying member’s eligibility on the dates of service.
Please verify eligibility by using one of the following methods for each date of service:
1. Web: www.sfhp.org/providers/
2. Interactive Voice Response: (415) 547-7810
3. SFHP Member Services: (800) 288-5555
Obtaining Prior Authorization For Service
Please fax all requests according to the member's line of business listed in the following directory, including the member's name, SFHP identification number, CPT and ICD:9 codes and site of service. In addition, provide clinical notes to support your request.
Prior authorization of services is required for all procedures, out-of-network referrals (i.e.: a CHN member consulting with a UCSF specialist) and inpatient admissions. Referrals within a member's medical group do not require prior authorization.
Service Coverage Inquiries
Please email (preferred) or fax all inquiries according to the member's medical group listed in the following directory, including the member's name, SFHP identification number, CPT and ICD:9 codes and site of service.
| Medical Group | Phone | Fax |
| Brown & Toland Physicians | (415) 972-6002 | (415) 972-6011 |
|
Community Health Network
|
(415) 547-7818 x 7080 |
(415) 357-1292 (outpatient services) |
|
UCSF
|
(415) 547-7818 x 7080 |
(415) 357-1292 (outpatient services) |
|
Chinese Community Health Care Association |
(415) 955-8800 x 3286 or x3238 (outpatient services) (415) 955-8800 x3239 (inpatient admissions) |
(415) 398-3669 |
|
Kaiser Permanente San Francisco
|
(415) 833-2807 |
(415) 833-2657 |
|
North East Medical Services
|
(415) 352-5045 |
(415) 398-1742 |
|
Hill Physicians
|
(800) 445-5747 |
(925) 820-4311 (outpatient services) |
Accessibility Statement
