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Member FAQs

Frequently Asked Questions

What is an IPA?

IPA stands for "independent physicians association". Independent physician means physicians in private practice, in contrast to physicians who are employees of a corporation, such as a hospital or HMO.

What is a PCP?

PCP stands for "Primary Care Physician". PCPs include general and family practitioners, internists and pediatricians. The primary care physician is responsible for providing primary medical care and coordinating specialty care for all patients who have been assigned to him or her.

What is Key Medical Group?

Key Medical Group is an independent physicians association. We act as the "middle man" between physicians and your health plan.

How do I change my PCP?

You must contact your health plan to request a PCP change. The effective date is generally not until the first of the following month. Most often you can only change your PCP on a monthly basis, but that depends on your health plan and any special circumstances. After changing your PCP you should expect to receive a new card within a few weeks. If you don't you should contact your health plan. See your insurance ID card for the member service phone number.

How do I obtain an authorization to see a specialist?

You must contact your PCP to request an authorization. In some cases you will need to have an appointment with your PCP to evaluate your need for a referral to a specialist.

How can I be sure my services will be covered?

Please contact your health plan to confirm your benefits.  You may refer to our resource page or you may find the phone number on your ID card. 

How can I change my address?

Please contact your health plan to change your address.  You may refer to our resource page or you may find the phone number on your ID card.  

How can I file a complaint against my physician or medical group?

Each health plan have different process for filing grievance.  You may refer to our Filing an Appeal page for information.  To file a complaint against Key Medical Group, you may write your complaint and mail it to us at 3335 S Fairway Visalia, CA 93277.  Attn: Administrator