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City Officer: Lee, Edwin – Mayor – Filed: September 24, 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.

Date Contract Approved

September 19, 2014




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