Health Insurance Plans: Frequently Asked Questions About Insurance

Before you receive care at Stanford Health Care, we strongly recommend contacting your insurance company directly. You will likely need to provide them with our NPI and tax ID numbers to verify their participation as in-network providers for your specific insurance plan. If they’re out-of-network, be sure to find what you may need to spend out of your own pocket for care you know you’ll need now and would like to have in case your health needs change. 

Our physicians and hospital each have a NPI and tax ID number:

• Stanford Health Care Physicians Group NPI: 1437292927
• Stanford Health Care Physicians Tax ID: 77-0465765

• Stanford Health Care Hospital NPI: 1871543215
• Stanford Health Care Hospital Tax ID: 77-0465765

TIP: Whenever you speak with health plan representatives, it is beneficial to write down the name and reference number of your conversation for future reference.

When it comes to health insurance coverage, it’s essential to know what is most important to you, such as:

• Cost: Will you be paying a monthly premium or pay at point-of-service?  Will you need to pay out-of-pocket before your plan begins covering your services?  
  
  
• Access: Do you have a particular doctor(s) you want to see for primary care and/or specialty care? Do you prefer receiving your care at a specific medical facility (hospital, urgent care, clinic)? What network does my plan utilize?
  
  
• Medications: Will your plan cover any medications you’re taking now?
  
  
• Health services: Do you need a plan that covers acupuncture, physical therapy or other services? Find out how many times you can use these services per year.  

Stanford Healthcare offers several programs for patients who are underinsured or who do not have insurance coverage. 

We have financial counselors who can assist you by assessing your liability, connecting you with available funding sources such as Medi-Cal and Medicare, or determine if you’re eligible for charity care or financial hardship treatment. 

To learn more, visit Financial Counseling. 

You should receive an explanation of benefits (EOB) from your insurance company explaining how your claim was processed and/or paid. It will indicate the amount billed, paid, denied, discounted, not covered, and the amount owed by the patient.

If you have any questions about your EOB, be sure to contact your insurance provider.    

If you are unable to pay your bill, Stanford Healthcare offers several programs for patients who are underinsured or who do not have insurance coverage.  Learn more about our financial assistance and financial counseling services.