Sutter Pacific Medical Foundation doctors offer primary, specialty and complex medical care throughout San Francisco, Marin, and Sonoma Counties. Our 230+ physicians are dedicated to excellent patient care, combining the latest in medical knowledge and technology with a personal touch. The relationship between our doctors and Sutter Health facilities helps link both doctors and patients with local health care services, enabling the highest quality care.
Putting Patients First
The relationship between doctor and patient is most important when it comes to health care. Time and again, our patients recognize the personal attention our doctors give to their medical condition. Accordingly, our mission is to care, to innovate, and to excel.
To meet your health care needs, our team provides:
- High maintenance and disease prevention
- High standards for clinical quality and patient satisfaction
- Coordinated, comprehensive medical care
- Acceptance of most major health plans
- Multiple local options for physicians who welcome new patients
Making Medicine More Efficient
Our vision is to deliver the future of medicine- today. This means sharing best practices, adopting technology such as electronic health records and staying at the forefront of research and innovations- all while focusing on the valued relationship between you and your doctor.
Patients at our Sonoma and Marin County locations have online access to our electronic health record system, My Health Online.
With My Health Online, you have 24-hour secure access to your medical records. You can make appointments, get prescriptions, check lab results, read physician instructions and update information via the Internet. This electronic health records system enables your doctor to work more efficiently and connect with colleagues and other Sutter facilities to deliver the best health care possible.
Convenient Care, Close to Home
Health care is about accessibility, availability and convenience. To deliver these features, our team provides more than 50 care centers in San Francisco, Marin, and Sonoma Counties, with additional outreach sites throughout Northern California and Nevada.
Coordination of Care
Sutter Pacific Medical Foundation's Utilization Management Program
Sutter Pacific Medical Foundation's Utilization Management (UM) program is designed to ensure that managed care members receive timely, medically necessary, and cost-effective care services.
Services that we provide to our patients as part of the program:
- Prior authorization/concurrent review
- Discharge planning
- Episodic Case Management
- Retrospective review
The managed care plans include Health Net, Health Net Medicare Advantage, United Health Care, United Health Care AARP Medicare Complete, Blue Shield, Anthem Blue Cross, Cigna, and Aetna.
Utilization Management Policies and Procedures
Sutter Pacific Medical Foundation uses approved guidelines from the health plans medical management policies, Centers for Medicare and Medicaid Services (CMS) and Milliman Care Guidelines criteria to review referral requests submitted by contracted providers and primary care physicians. These guidelines are reviewed and updated by these organizations periodically to remain current with new treatment and trends. The criteria provide a guideline only to approve, modify or deny care for persons with similar conditions. Specific care and treatment may vary depending on individual need a benefit covered under the individual’s plan. The criteria are available on request for a specific treatment.
Sutter Pacific Medical Foundation ensures that decisions are made only on appropriateness of care, service and existence of coverage. Sutter Pacific Medical Foundation managed care staff or providers do not receive any compensation, direct or indirect or financial incentives based on review decisions.
Sutter Pacific Medical Foundation encourages appropriate utilization and discourages inappropriate under-utilization by providers and staff.
Any questions regarding this notice may be directed to Sutter Pacific Medical Foundation's Utilization Management Department at 707-521-8800.
Sutter Medical Network
Our doctors are part of the Sutter Medical Network- a network of more than 3,500 Northern California primary care and specialist physicians. In San Francisco, Marin, and Sonoma Counties, the Sutter Medical Network includes Brown & Toland, Marin IPA and Sutter Medical Group of the Redwoods.