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FAQs


Answers to Frequently Asked Questions below.

General

1Why choose CHPC?
When a family chooses CHPC they are choosing:
  • A health plan led by pediatric experts from your community
  • The region’s largest group of pediatric and adolescent primary and specialty providers at convenient locations throughout San Diego and southern Riverside counties
  • California’s largest children’s hospital, which is nationally recognized for medical excellence
  • Services such as after-hours care, specialty programs and so much more
2How do I change my primary care doctor to a CHPC physician?
To change your primary care doctor, call the number on your member identification card. The health plan will make the change for you.
3How do I choose a CHPC pediatrician for my newborn?
  • Select a CHPC pediatrician for your newborn! Contact your employer within the first 30 days of birth to add your newborn to your health plan coverage.
  • Once your newborn is added to your insurance you can select a CHCP pediatrician.
4Where can I bring my child for urgent care services?
  • Please call your pediatrician’s office first. They offer advice 24 hours a day, 7 days a week.
  • Rady Children’s Health Network offers a network of urgent care locations throughout San Diego and southern Riverside counties.
  • If it is life or limb threatening, call 911.
5What happens when my child needs to see a specialist?
  • Your child’s pediatrician will refer you to a specialist in the network.
  • Many services do not need a prior authorization. Your pediatrician is able to provide a direct referral to most specialists.
  • If a prior authorization is required your doctor will help you with the authorization.
6How do I file an appeal, compliant or grievance?
If your doctor requested services for you and you do not agree with the decision, you have the right to file an appeal.
If you need to file an appeal or grievance, please call the number located on your health plan member ID card.
 
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