Provider Reimbursement

Provider Grants
HSF Medical Homes have different models of payment. HSF’s third-party administrator (TPA),
San Francisco Health Plan, administers HSF provider agreements and grant payments to
non-San Francisco Department of Public Health HSF Medical Homes and facilities.

Providers are required to submit their monthly invoices with the required enrollment and encounter data information. Payment is processed by the fifteenth (15th) of each month, provided that an invoice has been submitted with the required information.

Point of Service Fees
Some program Participants may pay a Point of Service Fee to their clinic at the time services are received. For example, an additional fee will be paid each time a Participant visits a physician, emergency room, or picks up a prescription. The amount of the Point of Service Fee depends on the Medical Home and household income of the program Participant. If a Participant’s income is below a certain amount, that Participant will not pay a Point of Service Fee for most services.

For more information about Point of Service fees, click here.