Hospitals
The San Bernardino County Medical Society (SBCMS) is a non-profit organization that serves the professional needs of its members--physicians who are dedicated to advocating for the best quality healthcare for patients.
In this section of the website, you will be able to find a physician, learn more about the complexities of your health insurance, locate hospitals within the Inland Empire (San Bernardino/Riverside Counties) and get links to valuable healthcare related websites. We regularly add new and updated information to the site, so bookmark this page and check back often. If you can't find what you need, please let us know by sending an email to Linda Sue Myers, Senior Administrative Assistant, at lmyers@sbcms.org.
We strongly encourage patients who need to find a physician of any specialty in their area to use our SBCMS Physician Locator. Thank you for visiting our website, and be sure to thank your physician for being a member of the San Bernardino County Medical Society.
Hospitals
Listed below you will find an alphabetical listing of all hospitals in San Bernardino and Riverside counties.
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Arrowhead Regional Medical Center
Ballard Rehabilitation Hospital
Barstow Community Hospital
Bear Valley Community Hospital
Behavioral Medicine Center, Loma Linda University
Canyon Ridge Hospital
Chino Valley Medical Center
Colorado River Medical Center
Community Hospital of San Bernardino
Corona Regional Medical Center
Desert Regional Medical Center
Desert Valley Hospital
Eisenhower Medical Center
Hemet Valley Medical Center
Hi-Desert Medical Center
Inland Valley Regional Medical Center
John F. Kennedy Memorial Hospital
Kaiser Permanente Fontana Medical Center
Kaiser Permanente Riverside Medical Center
Kindred Hospital Ontario
Loma Linda University Medical Center East
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Loma Linda University Medical Center
Loma Linda University Children’s Hospital
Menifee Valley Medical Center
Montclair Hospital Medical Center
Moreno Valley Community Hospital
Mountains Community Hospital
Naval Hospital
Palo Verde Hospital
Parkview Community Hospital Medical Ctr.
Patton State Hospital
Rancho Springs Medical Center
Redlands Community Hospital
Riverside Center for Behavioral Health
Riverside Community Hospital
Riverside County Regional Medical Center
San Antonio Community Hospital
San Gorgonio Memorial Hospital
St. Bernardine Medical Center
St. Mary Medical Center
VA Loma Linda Healthcare System
Victor Valley Community Hospital
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Health Insurance 101
SBCMS provides the following information to help you choose the health insurance plan that's best for you. Note: There are differences between plans of the same basic type (for example, not all HMOs are the same), so be sure to read all materials provided by your employer and the health plan carefully.
Traditional Health Insurance
Traditional health insurance is generally the most flexible type of health plan. It allows you to choose any doctor you want to and see specialists without first getting approval from a "primary care physician" or "gatekeeper." However, depending on the plan, certain restrictions may apply. For example, you may need to get the insurance company's approval before checking into a hospital, unless it is an emergency. With traditional health insurance, you will usually have to spend a certain amount on medical bills each year before your insurance starts to pay. This is called a deductible. After that, you will have to pay a percentage of each charge, called a co-payment. The insurance company will pay the rest of the charge based on what it considers reasonable. Many insurance plans protect you from large medical expenses by limiting your total expenses in any given year, called your out-of-pocket maximum. There may also be a cap on total benefits, a maximum amount the insurance company will pay in your lifetime.
Traditional health insurance is generally more expensive than other types of health plans and may require you to do more paperwork to file claims. Traditional insurance companies are regulated by the California Department of Insurance.
HMO (Health Maintenance Organization)
There are several types of HMOs. Most will only cover your expenses if you go to a healthcare provider within their organization (unless it's an emergency or you're out of town). They may require that you choose a primary care physician who will coordinate your care. And you will probably have to get approval from that physician before seeing a specialist. You must get approval from the HMO before entering a hospital or receiving some other kinds of non-emergency care. Most HMOs do not require that you meet a deductible each year and require only a small co-payment (for example, $10 per visit or prescription). Most of the paperwork is handled by the organization. HMOs are regulated by the California Department of Managed Health Care.
PPO (Preferred Provider Organization)
PPOs are generally less flexible than traditional health insurance plans but more flexible than HMOs. You can see any healthcare provider you want to (including a specialist), but your co-payment will be higher if the physician you choose is not a "preferred provider," that is, a physician the health plan has a contract with. PPOs will almost always require that you get their approval before entering a hospital. But they are more likely to cover checkups and other preventive medical services than traditional health insurance plans, and most preferred providers will file your claims for you.
POS (Point of Service)
A POS plan is similar to an HMO in that you can see physicians within a network and pay only a small co-payment. But you can also see physicians that aren't in the network and pay a percentage of the charge, after you've met your deductible, as you would with a PPO plan. There may be restrictions on the services you can receive outside the network with a POS plan. For example, prescription drugs, organ transplants, treatment for infertility, and mental health services may not be included.
EPO (Exclusive Provider Organization)
An EPO is similar to an HMO except that it is regulated by the California Department of Insurance and generally pays physicians and other healthcare providers differently. EPOs will only cover your expenses if you see a physician that is in the EPO's network, unless it is an emergency.
HSA (Health Savings Account)
The Health Savings Account (HSA) was created recently by federal legislation. A HSA lets you set aside pre-tax dollars for future medical, retirement, or long-term care premium expenses. You can invest these funds as you wish within a broad range of choices, then use them for qualified expenses. The funds can roll-over from year to year and can be taken with you when you change jobs, which makes an HSA different from other kinds of tax-advantaged savings accounts. Note: If you are still not sure which type of plan to choose, ask for more information from the health benefits manager at your workplace or a health plan representative. Your physician may also be in a good position to help you compare plans since he or she is familiar with your health and medical history.
Insurance Company Complaints
At SBCMS, we support the patient's right to access crucial healthcare services. This guide will walk you through how to file a complaint against your insurance company if you believe that your healthcare rights have been wrongly denied.
Overview
How to Fight Your Insurance Company When Coverage is Denied Should you have to battle your health insurance company over a denial of coverage, there are steps you can take to avoid health insurance denials before they occur. And if that does not work, there are steps you can take to fight them once they do. The key is organization--having all your paperwork in order, taking detailed notes of your interactions with everyone in the process and understanding your coverage.
Knowledge is Power
Information is power, and this is never truer than when battling a healthcare system. The winner may be the side with the better-organized, more-detailed information. The best bet when dealing with insurers is to minimize the risk of denial, and then if one does come your way, to solve the problem in the early stages.
- Understand your health insurance policy thoroughly. If you have questions or do not understand any aspect of your coverage, call your insurance company and make them explain it in layman’s terms. Make sure you understand the exclusions and limitations of the policy, and the section on how to appeal.
- When receiving medical care, make sure your healthcare provider understands what is covered. Doctors deal with many patients and many insurance companies. Do not assume they will remember the particulars of your situation.
- Take your policy provisions seriously. If it dictates that prior authorization is required, then do not receive care without obtaining that authorization. Assuming that the company will cover you and you can obtain coverage later, even if that is what your doctor tells you, could lead you into a world of bureaucratic nightmares, and might lead to a denial of coverage.
Avoid Denials of Care: Maintain Complete Records and Documentation
You are your own best advocate. You know best what ails you and what questions and concerns you have about your treatment. Take yourself seriously--be your own advocate at all times. Here are some steps to help avoid denials of care and coverage by your health care provider before they occur:
- Maintain an ongoing medication log documenting all medications and treatments you are currently using.
- Always try to bring another person to your doctor appointments. He or she can listen and take notes to help you remember what the doctor tells you. Even your own list of questions can fail you if you do not feel well or the questions are not addressed in the order you've written them in.
- Create a file folder to keep all documents, logs, test results and medication lists so that all your pertinent health information is in one place. Save copies of all paperwork from your doctor and your insurance company. Keep these records in chronological order for easy location.
- Maintain a detailed log of all health care services and communications (phone, in person, mail, etc.) that you have with your physicians, health insurance company, and any other person spoken to. This cannot be overstated. This log will greatly benefit you should you ever encounter access issues for medications, treatments or procedures.
- If using an out-of-network provider, establish before care is provided that they will accept your health insurer's payment in full.
- If there is a claim for which your insurance company will reimburse you only after you've paid your provider out of pocket, be sure to file the claim immediately.
- If there is a delay in payment, call your insurance company immediately.
If Care is Denied
Assuming you have taken all the above mentioned steps and are still denied coverage, do the following:- Review all the paperwork regarding the case immediately, making sure you understand every aspect. Then, with your paperwork in front of you, call your insurance company.
- The insurance company representative should be able to tell you why you were denied coverage. Make sure you take detailed notes of the conversation.
- Denial of coverage is often a result of administrative error. If this is the case, you may be able to resolve it on the first call, or with just some minor communication thereafter.
- Assuming the problem continues, request an itemized bill from the doctor or hospital, and analyze every charge. There are often charges on these bills for services not delivered. If you find any, notify the doctor or hospital immediately to get the bill adjusted. Then, notify your insurer.
- Often, however, the denial has been legitimately issued. The insurance company may not consider your medical procedure necessary, may consider it experimental or outside their coverage evidence based guidelines. That being the case, it is now time to take additional steps.
- Request a formal review by the insurance company. The customer service representative can tell you the specific procedures required. Then, state your case for appeal in writing, and send the letter via certified mail with return receipt requested. Make sure to do this immediately. Some companies have time limits on when appeal requests can be filed.
California Health Plan Complaint Process
Who Regulates What Type of Health Plan?
The majority of California’s health plans are regulated by either the California Department of Insurance (CDI) or the California Department of Managed Health Care (DMHC). The CDI regulates point-of-service health plans and certain Preferred Provider Organization (PPO) health plans underwritten by health insurance companies authorized by the CDI.
The CDI does not regulate Health Maintenance Organizations (HMOs) or certain PPOs, which fall under the Knox-Keene Act (i.e. Blue Cross of California or Blue Shield of California).
For a list of health insurance companies regulated by the Department of Insurance, visit their website at www.insurance.ca.gov. For a list of the HMOs and other healthcare service plans regulated by the Department of Managed Health Care, please visit the DMHC website at www.dmhc.ca.gov
- view all the paperwork regarding the case
- Understand your health insurance policy thoroughly.
Helpful Links
SBCMS is an advocacy organization supporting physicians and their patients. We do not resolve specific patient inquiries such as bills or claims, medical necessity or similar complaints patients may have regarding insurance companies, health plans or physician offices. There are many excellent resources devoted to helping patients with these concerns. Below are some resources that may be of assistance:
The HMO Help Center is a part of the DMHC. The DMHC oversees HMOs and some other health plans in California. The HMO Help Center can help you with your complaint and can also provide you with an Independent Medical Review (IMR), if you qualify. Call 888-HMO-2219; the TDD line is 877-688-9891. The HMO Help Center is open 24 hours a day, 7 days a week and can provide help in many languages.
The CDI regulates point-of-service and certain Preferred Provider Organization (PPO) health plans. The CDI toll-free number, dedicated to the handling of complaints and inquiries is 800-927-HELP for all areas of California except area codes 213, 310, and 818, for which you should dial 213-897-8921; the TDD line is 800-482-4833. The CDI also provides a simple complaint form, which is available at www.insurance.ca.gov.
Free individual counseling about Medicare and other health care issues is available through the Health Insurance Counseling and Advocacy Program (HICAP). HICAP counseling is available in every county in California. For counseling or more information call 800-434-0222 or visit www.cahealthadvocates.org.
The Medi-Cal Managed Care Office of the Ombudsman helps solve problems from a neutral standpoint to ensure that Medi-Cal patients receive medically necessary covered services for which plans are contractually responsible. The Ombudsman considers all sides in an impartial and objective way and develops fair solutions to health care access problems. Contact 888-452-8609.
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Preformulated MEDLINE searches are included in MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.
Patient Support Groups
- Alcoholics Anonymous
- ALS Association (Lou Gehrig’s Disease)
- Alzheimer's Association
- American Cancer Society
- American Diabetes Association
- American Heart Association
- American Liver Foundation
- American Lung Association
- American Red Cross
- Arthritis Foundation
- Autism Society of America
- Crohn’s & Colitis Foundation of America
- Cystic Fibrosis Foundation
- Easter Seal Society
- Epilepsy Foundation
- Fibromyalgia Network
- Juvenile Diabetes Foundation International
- Life Stream (Blood Bank)
- Lupus Foundation of America
- Muscular Dystrophy Association
- National Kidney Foundation
- National Multiple Sclerosis Society
- Neuropathy Action Foundation
- United Cerebral Palsy
- Visiting Nurse Association
- American Cancer Society
- American Diabetes Association
- American Heart Association
- American Liver Foundation
- American Lung Association
- American Melonoma Foundation
- American Red Cross
- Arthritis Foundation
- Autism Society of American
- Burn Institute
- Community Clinic Association of Los Angeles County
- Crohn's & Colitis Foundation
- Cystic Fibrosis Foundation
- Devic's Disease / NMO
- Epilepsy Foundation
- Fresh Start Surgical Gifts
- Hemophilia Association
- Huntington's Disease Society of America
- Juvenile Diabetes Research Foundation
- Leukemia & Lymphoma Society
- Lupus Foundation of Southern California
- Mental Health Association
- Muscular Dystrophy Association
- Myasthenia Gravis Foundation, San Diego Chapter
- NAMI (National Alliance for the Mentally Ill)
- National Kidney Foundation
- National Multiple Sclerosis Society
- Neuropathy Action Foundation
- Sickle Cell Disease Association of America
- Spastic Paraplegia Foundation
- Transverse Myeltits Association
- United Cerebral Palsy
