Ethics Commission
City and County of San Francisco

City Officer: Board of Supervisors – Filed: September 16, 2014 – Contractor: Toyon Associates, Inc.

Nature of Contract

  • On-site eligibility workers screen all referred unsponsored medical Acute admissions by San Francisco General Hospital Eligibility Staff and all acute Psych admissions for Medi-Cal and other federal, state and local health care programs.
  • Secure authorization to represent the patient and complete Medi-Cal applications and/or any other new federal, state, and local programs, i.e. those under the Affordable Care Act. Including the referrals for undocumented Aliens.
  • Represent the patient in Fair Hearings or all other State or legal appeals proceedings, if applications are denied.
  • Appeal Medi-Cal Field office or other Pre-Treatment Authorization program denials for care.
  • Investigate possible third party liability or Workers Compensation reimbursement. File liens to protect the City and County’s interest whenever appropriate or possible.
  • And others.

Date Contract Approved

September 9, 2014

Amount

$4,996,617.00

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