PFMC administers three types of provider networks: a preferred provider organization (PPO), an exclusive provider organization (EPO), and a worker’s compensation organization (WCO).

Our PPO is part of the largest provider network in California and is used by a long list of health plans and self-insured employers. The EPO is a smaller network in which providers agree to greater discounts and expanded utilization review. The WCO is for worker’s compensation cases. All our providers are automatically enrolled in the PPO network and have the option of joining the EPO and WCO networks.

Providers in the networks agree to accept PFMC’s fee schedule and to have their medical services reviewed by peers in their field. Providers also agree to bill on behalf of the patient and to accept the PFMC allowable as payment in full, less the patient’s responsibility for copayments, deductible, or coinsurance. There are no restrictions on in-network referrals.

For more information on joining the PFMC networks, contact:

Kathy Pass
PFMC
3033 Cleveland Ave., Suite 104
Santa Rosa, CA 95403
800-548-7677, Ext. 281
707-525-4281
Fax: 707-525-4311
kpass@rhs.org