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Because
the Stanislaus
Foundation for Medical Care is made up of
physicians, it is interested in you and your health.
That's what the Foundation is all about!
What
is Stanislaus Foundation for Medical Care?
Please
visit http://www.cfmcnet.org
to access up-to-date provider information. CFMC
provides physician panels, claims administration, medical
review pre-certification service, and large case
management through its component members. Currently,
CFMC covers over 1 million people statewide, including
321,387 lives in the Central Region.
The Stanislaus Foundation for Medical Care (Stanislaus
Foundation) was formed by the physicians of the Stanislaus
Medical Society and was established to guarantee the
delivery of quality medical care on a pre-payment basis at
a just and equitable cost to both patient and physician.
Stanislaus Foundation, incorporated as a non-profit
organization in 1957, is a health management system
created and operated by local physicians to serve the best
interests of the public and professional community.
Stanislaus Foundation is part of the California Foundation
for Medical Care (CFMC) with over 400 hospitals, 27,000
physicians and 5000 ancillary providers statewide.
Consider
these advantages:
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CHOOSING
A
DOCTOR
OR
HOSPITAL
:
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COMPLETE
LOCAL CLAIMS PAYMENT SERVICE:
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As
a Stanislaus Foundation subscriber or dependent,
when you select the services of any doctor or
hospital that is a participating provider, payment
will be made directly to that provider in
accordance with your health services agreement.
Participating Providers will accept payment made
by Stanislaus Foundation as payment in full for
covered services (patients
are responsible for deductibles, co-payments and
charges for non-covered services).
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The
Stanislaus Foundation is a local organization
which receives and pays claims out of its
Modesto
office. In this way, both patient and the provider
of care have the advantage of easy access to
claims payment information... without having to
contact an office a great distance away. Your
doctor or other health care provider can mail his
claim directly to the Foundation. The Foundation
will review the claim and, if the doctor is a
Foundation member (a large
majority are) or an assignment of benefits
is attached to the claim, payment can be made
directly to the doctor. You will receive an
itemized copy of the payment notification.
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SPONSORSHIP
IS AVAILABLE TO SELF-FUNDED GROUPS:
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CERTAINTY
OF COVERAGE:
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The
Stanislaus Foundation provides the same structure
benefit guarantees and cost containment programs
to self-funded health plans that are available to
Foundation sponsored, commercial insurance
pre-paid health programs. Excessive health care
insurance costs can be reduced when highest
quality care, with claims and adjustments by physicians
peers, blends with expedient local processing to
create real dollar savings.
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To
assure that each patient covered under a
Stanislaus Foundation sponsored health insurance
program receives adequate coverage, Stanislaus
Foundation has established standards for health
insurance programs. These standards are designed
to require a benefit structure which will protect
all covered individuals.
- Experience
of over 43 years of service to the Community
- Fast
local personalized service
- Hospital
utilization and ambulatory peer review
- No
claim forms
- Free
choice of physicians and hospitals - world
wide, unlimited access
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As
health expenditures increase and medical choice and
services decrease, businesses are evaluating more
cost-effective health care delivery mechanisms. Now, more
than ever, increased attention must be given to patients'
demands for quality care and protection from escalating
costs. The Stanislaus Foundation for Medical Care accepts
a leadership role in matters of cost containment,
professional service standardization and utilization
monitoring as the only way to inhibit non-professional
takeover of physician/patient prerogatives...
We
Care About Your Health Care!
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