Frequently Asked Questions
Members
How can I find a doctor in the Canopy Health network?
The best way to find a doctor in the Canopy Health network is to visit Find a Provider on CanopyHealth.com where you can search for doctors by location, specialty, and more.
Do I need a referral to see a Canopy Health network specialist?
Canopy Health values the judgment and expertise of personal primary care physicians (PCP), as well as their relationships with their patients. At Canopy Health, physicians have the entire Canopy Health network of specialists and facilities at their disposal and can decide (along with their patients) when and where to refer them for specialty care.
Can I change my primary care doctor?
Yes, you can look for a new doctor through Find a Provider on CanopyHealth.com. Once you select a new doctor, you must call your health plan at the number on the back of your ID card to request the change. Once your health plan confirms the change, you’re free to schedule your visit.
Employers & Brokers
What Medical Groups are associated with Canopy Health?
We have 5 Medical Networks spread throughout the 10 Bay Area counties, including Hill Physicians Medical Group (Alameda, Contra Costa, Marin, San Francisco, San Mateo, Sonoma, and part of Solano County), John Muir Physician Network (Contra Costa, Alameda Counties), Providence Medical Network (Sonoma, Napa Counties), Dignity Health Medical Network (Santa Cruz County), and SCCIPA (Santa Clara County).
How does Canopy Health differ from a non-Canopy health plan option?
We partner with UnitedHealthcare and Health Net who offer the health plans that feature our Canopy Health Network. Â Their plans that include the Canopy Network allow members to access their care with any of our providers, hospitals, and urgent care centers throughout the Bay Area. If a member needs to see a specialist outside of their medical group, the primary care physician can refer them to any doctor in the Canopy Health network. With a traditional HMO, members typically cannot see doctors outside their assigned Medical Network. Â
Can members get care outside of the Bay Area?
If you are outside of our ten-county service area and require emergency or urgent care your benefit plan covers those services. Non-emergency care is not covered outside of the Bay Area.
Is Stanford or Sutter in your network?
No. To see which hospitals and physicians are in our network, visit our service area page.
Providers
Does Canopy Health Manage Authorizations and Claims for Medical Services?
Canopy Health’s medical groups support the traditional functions for their assigned members, including coordination of referrals, authorizations and care management, as well as physician contracting and claims processing for services that are their financial responsibility.
What’s not included in the Alliance Referral Program?
Lab testing: any medically necessary tests should be referred to the Member’s IPA/Medical Group’s contracted laboratory. See Lab Services grid by IPA/Medical Group. We encourage physicians to refer to the Member’s IPA/Medical Group’s contracted imaging centers.
Who can I contact for questions about the Alliance Referral Program?
For more information on the Alliance Referral Program, please email CHAllianceReferrals@CanopyHealth.com Monday-Friday 8:30am – 5:00pm PST (closed holidays).
Where should self-injectables prescriptions be sent?
Self-Injectable Medications are authorized and paid for by the parent health plans (UnitedHealthcare or Health Net). For contact information, see the Provider Manual.
