Parent Resources

Your Child's Health Plan Benefits

CPCMG is an integrated medical group of health care physicians. We contract with many insurance companies that offer a variety of coverage and plans, but we are not an insurance company. We are pleased to accept most indemnity, PPO, Medi-Cal and HMO plans. For patients with HMO coverage, your plan requires you to select a CPCMG physician as your child's primary care physician (PCP).

Due to the complexities of insurance policies, it is extremely important for you to become familiar with your specific health benefits and payment obligations. These may include co-payments, deductibles, coverage exclusions and out-of-area provisions. If you have any questions, please contact your health insurance carrier directly. The number is listed in your benefit plan booklet and health insurance identification card. We suggest that you carry your dependents' health insurance identification cards at all times.

New Parents:

It is very important that you notify your insurance carrier within 30 days to add your new baby to your policy. Depending on your specific policy, if you do not notify your insurance carrier within the 30-day time frame, there is a possibility your child may not be added to the plan until the following open enrollment period. In this instance, you may become financially responsible for all services provided to your newborn.

New Patients:

Please plan to arrive at least 30 minutes prior to your child's appointment to register. You will be asked to complete pertinent health and insurance information. Bring your insurance card or proof of insurance coverage with you. It is extremely important that you bring your child's immunization record and any other medical information. Download the registration forms.

Financial Policy Statement

Your insurance requires that you be responsible for all co-payments, deductibles, and non-covered benefits. CPCMG is legally obligated to collect these payments. Please do not request that we adjust these payments from your account. As a courtesy to you, our Business Office will bill your insurance for you. Please remember you are ultimately responsible for your bill. Timely payment will be expected.

  • Payments are due at the time of service. If you are not accompanying your child to the visit, please ensure provision of payment at time of service.
  • We accept cash, checks, Mastercard, Visa, or Discover.
  • All balances not paid in full are subject to a finance charge of 2% for each month that such balance remains outstanding.
  • If any outstanding balances are assigned to an outside collection agency, the parent or legal guardian is responsible for the costs associated with such collection, including attorney's fees.
  • In the case of divorced parents, please remember that both parents are financially responsible for the child. The parent accompanying the minor is responsible for any co-pays due at the time of service.

Updating your child's Information

It is extremely important that you notify us as soon as possible if there is a change of name, address, telephone number or insurance. You may notify us by:

  • Calling the Customer Service Department at 858/502-1100
  • Calling your Child's office
  • Update at your child's next visit by notifying the front desk at check-in

Billing Questions

Our Patient Financial Services Department is available for questions regarding your CPCMG Account. Our staff can be reached, Monday through Thursday, 8:30 a.m. to 4:30 p.m. and Friday 8:30 a.m. to 4:00 p.m. at (858) 502-1100. If you have Medi-cal coverage or other low income coverage please call (858) 502-1120.

"Low to No" Cost Medical Coverage

HEALTHY FAMILIES

The Healthy Families Program is a low cost insurance that provides health, dental and vision coverage to children who do not have insurance today and do not qualify for the no-cost Medi-cal coverage.

When you enroll your children in Healthy Families, you choose your plan. This insurance pays most of your children's costs for visit to medical professionals

Who may qualify?

  • Children up to their 19th birthday
  • Children in the family without employer-sponsored health insurance in the last 3 Months
  • Children living in California
  • Children that are not eligible for "no-cost" Medi-cal
  • Children who meet citizenship or immigration rules
  • Children born to mothers enrolled in the Access for Infants and Mother (AIM) Program, who are not enrolled in the full scope Medi-cal program or employer sponsored health insurance
  • Children I families with incomes within the Healthy Families Guidelines

To reach the Healthy Families Program with more questions or to download an Application you can call Toll-free 1/800/880-5305 or go to http://healthyfamilies.ca.gov/English/about.html.

CALIFORNIA CHILDREN’S SERVICES (CCS)

CCS is a state program that can help your child get special medical services. Your child may be eligible for CCS services, if he or she has a physical problem or serious illness. Some of the problems CCS can help with are:

  • Cleft Palate
  • Premature babies
  • lung disease
  • Cancer
  • cerebral palsy
  • birth defects

What does CCS provide?

There are many services your child can get through CCS, they will pay for tests needed to find about problems, special medical supplies, and therapy.

Who can get CCS services?

  • Children under 21 years of age
  • Has a problem covered by CCS
  • Child meets the financial criteria by CCS

How do children get care from CCS?

Anyone can refer a child to CCS. You can call or mail the referral form to the county office of CCS with Medical Records. However, only a CCS provider can render care to your child. Ask your doctor for a referral form if you need one. For more information call your San Diego CCS office at 619-528-4000.

Your Child’s Appointment

General Information

  • Call our offices during regular business hours to schedule an appointment.
  • When visiting your doctor’s office, bring your health insurance identification card and co-payment, if applicable.
  • It is important that all exams are scheduled and proper information is documented in each patient’s medical record. Our physicians may not be able to examine children brought along with you who do not have an appointment.
  • After your child is an established patient with our medical group and you are unable to accompany him for his visit, you must send a note signed and dated by you with the following information:
    • The name of the person accompanying your child.
    • Permission to see and treat your child in your absence.
    • Permission for any immunizations that your doctor may recommend.

New Patient Appointments

  • Patients who are being seen by a CPCMG physician for the first time should arrive 30 minutes early in order to complete necessary paperwork. Our patient registration form and health questionnaire can be found on our Web site at www.CPCMG.net. If you have access to the Internet, print and complete these forms and bring them with you to your child’s first appointment.

Routine Appointments (Well-Exams, School/Camp/Sports Physicals, Immunizations)

  • These appointments need to be scheduled four to six weeks in advance so that we can better accommodate your choice of day and time.
  • If you need us to complete any forms (such as school, sports or camp physicals), please call ahead and check with our office to see if your child needs an exam before we can complete the forms.
  • It is extremely important that you bring in your child’s immunization card. Please note: There is a charge to replace a lost immunization card.
  • Arrive 20 minutes prior to scheduled appointment time.

Immunizations

  • California law requires that your child be immunized before enrollment in public or private schools. Please discuss your child’s immunization schedule with your child’s physician.

Walk-In Policy

  • Walk-in patients with non-urgent conditions will be given the next available appointment, which may be on another day. It is best to call ahead and schedule an appointment. Some offices have scheduled walk in days and hours. Please inquire your specific office for this.

Late-Show Policy

  • Patients who arrive late for their scheduled appointment time may be given the next available appointment, which may be on another day. Patients who repeatedly arrive late may be asked to find another pediatrician.

Cancellation / No-Show Policy

  • We ask that you call our office 24 hours in advance (or as early as possible) if you need to reschedule or cancel an appointment. Patients who repeatedly fail to show or keep their appointment may be asked to find another pediatrician.

Please remember while visiting our offices:

  • We would appreciate your help in not bringing food into our offices.
  • Please refrain from using cell phones while in the exam room.

Prescriptions

New Prescriptions

In the majority of cases, new prescriptions cannot be written without a physician examining your child.

Refills

If you need a refill, please call your pharmacy directly. Note: It may take up to 48-hours for your refill request to be completed. Do not wait until your child’s prescription has run out before calling.

Referrals for Specialty Services

There may be times when your child may need to be referred to a specialist. Whenever possible,we prefer to refer to a pediatric specialist. Pediatric specialists are physicians who dedicate themselves to helping children with specific medical or surgical needs. Like pediatricians, they have completed medical school and residency programs, but also have additional in-depth fellowship training to focus on the clinical and research aspects of their specialty.

The goal of the referral process is to ensure that patients are provided with an appropriate level of care including:

  • Services that are medically necessary.
  • Guidelines, standards of medical practice and criteria set by governmental and other regulatory agencies that are adhered to as appropriate.
  • Authorized quality care that is offered in a timely manner. Your physician’s office will facilitate all referrals for specialty services. Some insurance carriers require us to obtain authorization for the referral prior to the specialty appointment. Depending on your coverage, the authorization for specialty services may take one to two weeks for a non-urgent referral.You will be notified of the approval once we receive it. We will then provide you with the telephone number to call to schedule the appointment.

For specific information on the status of a referral, please contact the referral coordinator at your primary care physician’s office.

Your Child’s Medical Record

The medical record is the physician’s documentation of the care given to your child. This is a written, continuous record that includes visit notes, lab results, x-ray reports, diagnoses and treatments, and any medication given. It is important that your child’s medical records be complete. Therefore, please inform our office if your child has been seen by another physician. We can then decide if we need to request copies of prior medical records.

CPCMG respects and protects the privacy of patients’ medical information. We believe that patients have the right to have their medical information kept confidential. CPCMG takes patient privacy seriously and follows state and federal privacy policy guidelines. CPCMG’s Privacy Officer is available to handle any questions or concerns related to privacy issues. Our Privacy Officer can be contacted at (858) 502-1125 You may request a copy of CPCMG’s Notice of Privacy Practices at any CPCMG location or by visiting our Web site at www.CPCMG.net.

Should you need your child’s medical record transferred to a non- CPCMG physician, please contact our office to sign a medical records release form. Copies of the medical records will be transmitted within 15 days after receiving the written request. There will be a charge for copying medical records, unless the request comes directly from another physician’s office.

Telephone Advice

The after-hours triage line is for urgent calls only. When you call a CPCMG office after closing, each office will instruct you on how to obtain medical care for your child. Please follow these simple rules so that you will receive advice in a timely manner.

  • If you think you have a life- or limb-threatening emergency call 911.
  • If you need to call the after-hours phone number, please make only one phone call and wait for a response. Please do not make multiple phone calls. Calls are screened and the most urgent ones are returned first. Please do not call from a blocked phone number or provide an unblocked phone number for the return call. Routine calls should wait for regular office hours. Examples of routine calls include minor feeding problems, behavioral questions, and mild diaper rashes.
  • Medication refills should only be done in the office during business hours when the staff has access to your child’s records. The after-hours staff may not be able to refill the medication because they may not know your child or have his chart available.
  • Over-the-counter medications should be used according to the information on the label.
  • Visit our Web site at www.CPCMG.net for more information regarding common illnesses.
  • You can also visit the Children’s Hospital Web site at www.chsd.org and click on the “Medical/Health Tips” for further information on caring for your child.

Be Prepared:

  • Give your child’s name, birth date, phone number where you can be reached, and your child’s doctor’s name.
  • If your child has a fever, take the temperature before you call.
  • If you have a question about medication, keep the medication container close by so you can tell the nurse exactly what it is.
  • Be ready to discuss your child’s symptoms.You will be asked several questions about your child’s illness.
  • Have pencil and paper available to write down instructions.

Triage Nurses:

  • The nurses from the triage team are all registered nurses.
  • The nurses have a standard list of questions that will help guide their advice.Your answers will help to decide the best way to aid your child.
  • The nurses cannot give you a diagnosis or prescribe medications. The main purpose of triage is to direct you to the appropriate level of care.
  • The calls are returned in order of urgency. The most urgent call will be returned first.

Urgent Services

It is important to consult with your pediatrician regarding the proper use of urgent care, and if possible, during routine office hours discuss whether your child’s medical condition warrants a trip to urgent care. Once the office is closed, the after-hours triage service or oncall physician will help instruct you about this decision. Urgent care is utilized for an injury or condition needing prompt medical attention. See section under Rady Children’s Hospital for listing of Urgent Care Centers.

Emergency Services

You should seek emergency care if your child experiences an injury or condition that could permanently endanger his health if not immediately treated. Whenever possible contact your child’s primary care physician first to determine what treatment is required. Remember to call 911 if your child’s injury or condition is life- or limb-threatening.

Rady Children’s Hospital - San Diego

If your child needs hospital, emergency, or urgent care, it is important that he be treated in a facility that is 100 percent dedicated to children. Rady Children’s Hospital - San Diego has been dedicated to serving San Diego’s children since 1954. It is the only pediatric hospital in San Diego County and has been named as one of the top children’s hospitals in the United States. The physicians, nurses, and staff are specifically trained to treat children with age appropriate medical equipment, diagnostics and medications. All of this is done in a physical setting designed exclusively for children and in an environment that promotes healing. Rady Children’s philosophy of “family-centered care” makes the family part of the healing process. Should your child need to receive care in a hospital setting, you will want to have access to Rady Children’s Hospital. Rady Children’s is located at 3020 Children’s Way, San Diego, California 92123. For more information visit their Web site at www.RCHSD.org or call (858) 576-1700.

Rady Children’s Emergency Care Center

The Sam S. and Rose Stein Emergency Care Center at Rady Children’s Hospital is the designated pediatric trauma center for San Diego and Imperial counties and is the only emergency care center in the region solely dedicated to caring for children. It is staffed by physicians, nurses, technicians and other professionals specifically trained in trauma and emergency care. Children are brought to Rady Children’s Emergency Care Center by private car, ambulance, helicopter, or transferred from other hospitals by Rady Children’s Hospital Emergency Transport (CHET) team.

All patients coming into Rady Children’s Emergency Care Center receive an immediate assessment as to the severity of their injury or illness. This evaluation determines the timing and degree of treatment required. More seriously ill or injured children receive top priority.

No one looks forward to a visit to the emergency department. However, it is comforting to know Rady Children’s Emergency Care Center is open and staffed 24 hours a day, 7 days a week to provide the expert care your child may need. As a reminder, in case of a life- or limb-threatening emergency, always dial 911.

Rady Children’s Urgent Care Centers - In Your Neighborhood

Children frequently become ill or injured when their pediatrician’s office is closed on weekends or evenings. Rady Children’s Urgent Care Centers are open after-hours to provide treatment to children needing urgent care for acute illnesses, minor lacerations, minor trauma and uncomplicated orthopedic injuries. Rady Children’s Urgent Care Centers are currently located in these San Diego County neighborhoods:

The locations and hours of operation of the Urgent Care Centers are subject to change. For up-to-date information about current locations and hours of operation, please call Rady Children’s Customer Service Center during regular business hours at (800) 788-9029 and ask about a Rady Children’s Urgent Care Center in your area.

Mid-City

4305 University Ave.
Suite 150
San Diego, CA 92105
(619) 280-2905

North County

625 West Citracado
Suite 100
Escondido, CA 92025
(760) 739-1543

East County

5565 Grossmont Ctr. Dr.
Building 2, Suite 2
La Mesa, CA 91942
(619) 713-5375