Affinity Members – Frequently Asked Questions
What do I do in case of an Emergency?
An Emergency is defined as a sudden illness or injury, such as a chest pain or uncontrolled bleeding. In cases of life-threatening emergency, go to the nearest emergency room or call 911.
For all other urgent care matters, there is a doctor on call at your physician's office 24 hours every day. The on-call doctor will advise you what to do next.
After any health crisis, it is important that you call your doctor's office, within 48 hours if possible, so that your doctor can be involved in your care.
When do I call my doctor, my health plan, or Affinity?
Call your PCP/Primary Care Physican's office for:
- Medical problems
- Appointments
- Referrals to specialists
Female Affinity patients can make appointments directly with one of our obstetrics/gynecology (OB/Gyn) specialists for routine care, and can also self-refer to our mammogram facilities. Contact your PCP to find out which OB/Gyns are available to you.
You can reach your PCP 24 hours a day for consultation. Please save routine matters for regular business hours.
Call your health plan for:
- Prescription drug and other benefit coverage information
- To change your doctor or your address
- To order ID cards
Call Affinity Medical Group Customer Service (1-888-309-2221) for:
- Assistance with billing problems
- Information on resources to manage your health
What is a "medical group"?
When you select HMO care and choose a primary care physician (PCP), you also choose his/her medical group. A medical group, like Affinity Medical Group is formed when PCPs decide to work together to serve a community. These PCPs contract with specialist physicians, hospitals, health plans and other health care providers to form a network. Sometimes they are called IPAs (Independent or Individual Practice Associations). Your most important relationship is with your PCP, but when you or your doctor need administrative support, you will find a friendly team of people at Affinity Medical Group Customer Care (1-888-309-2221), dedicated to helping you get the answers you need.
How is Affinity Medical Group different from other medical groups?
- A dedication to and familiarity with the East Bay, California region
- Close working relationships between Primary Care Physicians and local Specialists
- A wide range of health promotion programs for members
- Friendly and helpful customer service team
Affinity Medical Group works to keep you healthy and informed, and provides free health improvement programs when you need them most. Affinity assists with having good access to your PCP, and focuses on maintaining your good health.
What health plans are contracted with Affinity Medical Group? How do they work together?
For a list of the health plans affiliated with our medical group, please select the "Our Health Plans" link. Phone numbers and website links for all plans are provided.
If you would like more information on Medicare Advantage HMOs (health maintenance organizations), Affinity is contracted with Health Net Medicare Programs and AARP Medicare Complete from Secure Horizons.
When you join one of our contracted health plans, you can request any of Affinity's Primary Care Physicians as your personal doctor. Affinity Medical Group makes sure you receive all the medical care outlined in your health plan.
What is a Primary Care Physician (PCP)?
A Primary Care Physician (PCP) is the doctor you select to be your personal physician. He or she can be specialized in Internal Medicine, Family Practice or Pediatrics. The relationship you have with your PCP is very important. You will work with your PCP to manage your health, and he/she will authorize visits to most specialists when necessary (except for visits to OB/GYN specialists, which can be made without a referral).
How does my PCP work with Specialist physicians?
Each Affinity PCP has selected a number of specialist physicians to provide care to their patients. Your PCP has close working relationships with these network specialists, and will refer you to the specialist who best suits your needs.
What is an Authorization? How does it work?
You will need an "Authorization" from Affinity Medical Group to schedule a visit to a specialist physician. Please contact your PCP to request an authorization if you need to see a specialist.
What extra services are available through Affinity?
Affinity Health Institute is an organization that provides health improvement services for all Affinity Medical Group members. Currently, Affinity Health Institute offers FREE programs for weight management and smoking cessation. Speak with your Affinity PCP or call Affinity Customer Service, 1-888-309-2221 for more information.
Are my diabetic supplies or durable medical equipment covered?
Depending on your health plan, many of your medical supplies are covered under your benefits. Ask your Affinity PCP to make a referral for these items.
What do I do if I receive a bill for medical care?
If you feel you have received a medical bill in error, please contact Affinity Customer Service for assistance. Either call 1-888-309-2221 or send your bill to:
Affinity Medical Solutions
P.O. Box 21390
El Sobrante, CA 94820
