Member FAQs

What is an IPA?

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

Back to Top

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.

Back to Top

What is Key Medical Group?

Key Medical Group is an independent physicians association. We act as the "middle man" between the physicians and Blue Shield of California.

Back to Top

How do I change my PCP?

You must contact your health plan (Blue Shield of California) 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 our resource page to obtain your health plan member service number.

Back to Top

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.

Your PCP will submit an authorization request to Key Medical Group with chart notes, labs, x-rays, etc. Routine authorizations that are determined routine are processed within two working days.

Back to Top

How can I be sure my services will be covered?

Benefit options are set by your health plan. If you have questions about whether or not a service will be covered you will need to contact your health plan directly. See our resource page to obtain your health plan member service number.

Back to Top

How can I change my address with the IPA?

You would need to call your health plan member service number to update your address. See our resource page to obtain your health plan member service number.

Back to Top

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

You must contact your health plan to file a formal complaint/grievance. See our resource page to obtain your health plan member service number.

Back to Top