SERVICES

Key Medical Group is an Independent Physician Association (IPA) of primary care doctors and specialists who work together to provide excellent healthcare to our members.  Key Medical Group manages Alignment Health Plan, Blue Shield of California, Anthem Blue Cross, Health Net, Humana (Medicare Advantage), SCAN and UnitedHealthCare.  For more information about the health plans please refer to our Health Plan Contacts page.

  • Referrals

    Referrals to specialists must be coordinated by your Primary Care Physician (PCP), who is responsible for the overall management of your healthcare. Most referrals are confirmed by a referral authorization letter which includes the specialist name, number of visits and expiration date of the referral. Your Primary Care Physician should make arrangements for your appointments.  Prior authorization will need to be obtained prior to making any appointments for most services.

    Checking Referral Status

    Call Key Medical at (559) 735-3892.  We are available Monday through Friday from 8:00 AM-5:00 PM. You may also check with your doctor's office.

    Laboratory Services

    Laboratory services are capitated. Members assigned to Visalia or Exeter primary care providers are required to use Kaweah Health.  Members assigned to Tulare, Dinuba, Hanford, Corcoran, and Lemoore primary care providers are required to use Quest Diagnostics. Members assigned to Porterville and Lindsay are required to use Sierra View Medical Center. For locations of draw sites, please click here.

    Emergency Room Access

    Perhaps the most commonly denied service is medical care obtained through the emergency room or urgent care center. Often this results in angry responses from those denied coverage, as these services can be quite expensive. You can save yourself both time and money by following some general guidelines.

    Contact your primary care provider regarding your condition before going to the E.R. or Urgent Care Center. Often symptoms you consider emergent can be handled over the phone. Sometimes antibiotics can be prescribed for urinary tract, sinus, or ear infections. High fevers in children are rarely emergent and can be managed with combinations of Tylenol, Ibuprofen and a cool washcloth. Pain management; whether low back, headache, abdominal, or limb; can also be evaluated and treated over the phone depending on its severity. Vomiting and diarrhea can often be relieved by over-the-counter and prescription medications. It is important to call your doctor before going to the emergency room or urgent care center so he/she can best advise you on what to do.

    Certainly some conditions are so emergent that you do not have time to contact your physician. Sudden onset of severe chest pain, shortness of breath, loss of consciousness, weakness on one side of the body, new seizures and persistent fast irregular heartbeats are all indications of potentially serious conditions. Injuries resulting in an obvious fracture or open wound also require immediate care. In these cases, contact your physician the following day so they can request authorization for the E.R. or urgent care.

    Hopefully you will never need urgent/ emergent care. If you do, however, following these guidelines may save you time and expense in the future. If you and others follow these guidelines this may insure that the emergency room physician will be able to see you in a timely manor and reduce unnecessary time to see non-emergent conditions.

    Direct Access for Women

    Under the HMO’s, women have direct access to contracted OB/GYN’s within the Key Medical Group panel.  Direct access means the member can see the OB/GYN without a referral for evaluation and management services.  

    For a list of Key Medical Group contracted OB/GYN providers please go to our Physician Roster page and download the specialist file.

  • Laboratory services must be provided by your designated laboratory provider.  Your primary care provider's (PCP) location determines which laboratory facility you must use under your health plan.  Members assigned to Visalia and Exeter PCPs must go to Kaweah Delta District Hospital, members assigned to Tulare PCPs must go to Quest Diagnostics, and members assigned to Hanford, Corcoran, Dinuba, and Lemoore PCPs must go to Quest Diagnostics.  Members assigned to Porterville and Lindsay PCPs must use Sierra View District Hospital.  If laboratory services are performed other than the designated facility, the member could be held financially responsible for the payment.  Listed below are the following draw sites available to you.

    • Kaweah Health Medical Center-Draw Sites

      *Members assigned to Primary Care Providers in Visalia & Exeter

      VISALIA

      400 W. Mineral King (basement)

      Phone: (559) 624-2251

      Hours: M-F 7:00-6pm Sat. 7:30-4pm

      100 Willow Plaza, 3rd floor Ste. 301

      Phone: (559) 741-4727

      Hours: M-F 8:30-5:30

      (Closed for lunch 12:30-1:30pm)

      Kaweah Health South Campus

      (Next to Urgent Care)

      1633 S. Court St.

      Phone: (559) 624-6087

      Hours: M-F 7:30-5pm

      Sequoia Imaging Center

      4949 W. Cypress Ave.

      Phone: (559) 624-3200

      Hours: M-F 7:30-4pm

      (Closed for lunch 12-1230pm)

      Quest Diagnostics-Draw Sites

      *Members assigned to Primary Care Providers in Tulare, Corcoran, Dinuba, Hanford & Lemoore

      TULARE SITE

      Quest Diagnostics

      919 N. Blackstone St.

      Phone: (559) 684-1655

      Hours: M-F 7-4pm Sat. 7-12pm

      (Closed for lunch M-F 11:30-12:30pm)

      VISALIA SITE

      Quest Diagnostics

      131 S. Tamarack St. Ste. B

      Phone: (559) 738-1961

      Hours: M-F 6:30-3:30pm

      (Closed for lunch 11-12pm)

      HANFORD SITES

      450 Kings County Dr. Ste. 103

      Phone: (559) 582-0391

      Hours: M-F 7-4pm

      1120 N. Irwin St.

      Phone: (559) 582-0308

      Hours: M-F 7-4pm

      SELMA SITE

      1122 Rose Ave. Ste. 2

      Phone: (559) 891-1358

      Hours: M-F 7-4pm

      Sierra View Medical Center-Draw Site

      *Members assigned to Primary Care Providers in Porterville and Lindsay

      PORTERVILLE

      263 N. Pearson Dr.

      (North of ER Department)

      Phone: (559) 781-7877

      Hours: M-F 6:30-5:15pm

    For a complete list of available draw sites please download our Laboratory Services Draw Site Directory.

  • Sequoia Health Plan (SHP) is a partnership between Key Medical Group, Kaweah Health, and Sierra View Medical Center bringing together trusted local healthcare providers and resources to support the health and well-being of our members.

    With strong local roots and a focus on the unique needs of Medicare and Dual Eligible populations, our partnership helps make healthcare more connected, accessible, and effective. By combining our expertise and working as one team, we strive to improve health outcomes, enhance quality of life, and create healthier communities throughout the region.

    Your local care team consists of dedicated professionals committed to supporting you every step of the way. Your care team includes a Medical Director, Nurse Case Managers, Social Workers, Health Coaches, Pharmacists, and Pharmacy Technicians, all working together to help you achieve your best health.

    The Key Medical Virtual Care Team contact number:              
    (559) 802-1991

    Code: KEY

    If you aren’t already a Medicare Advantage Key Medical Group member and want more information please call: (559) 802-1991.


    Forms and Brochures

  • All appeals for denied services are handled directly through your health plan (Blue Shield, Anthem Blue Cross, etc…). A provider or patient may file an appeal.  An expedited appeal would be requested if it is determined that a delay in the decision making process might pose an imminent and serious threat to the patient's health.  If it were determined by the health plan that an appeal meets this criteria, an expedited review would apply to the case.  An appeal may be filed either by telephone, writing and with some health plans, online.  Once an appeal is in process, your health plan will notify Key Medical Group and will request a copy of your denial letter and any notes we've received from your physician. 

    Every health plan follows different guidelines and procedures.  For more information please refer to the health plan's Appeals & Grievance process available through their website.

    In addition to the process described above, you may also contact the California Department of Managed Health Care (DMHC). The DMHC is responsible for regulating health care plans.  The department has a toll free number (800-400-0815) to receive complaints regarding health care plans.  If you have a grievance against the health plan, you should first telephone the plan and use the grievance process before contacting DMHC.  If you need help with a grievance which had not been satisfactorily resolved, or has remained unresolved for more than 30 days, you may call the DMHC for assistance.

    IF YOU HAVE ANY QUESTIONS REGARDING THE AUTHORIZATIONS PROCESS, PLEASE FEEL FREE TO CONTACT THE KEY MEDICAL GROUP AT (559) 735-3892, 8 AM TO 5 PM MONDAY THROUGH FRIDAY. 

  • More information here.

  • Your privacy is very important to Key Medical Group. If you would like for Key Medical Group to speak to someone on your behalf you will need to complete the Information Release Form below and mail it to our office at Key Medical Group 3335 South Fairway, Visalia, Ca. 93277.

    Key Medical Group Forms