Managed Care

Gonzaba Medical Group (GMG) accepts original Medicare and Certain Medicare Advantage plans (listed below). If you want more information about Medicare Advantage plans and those accepted by GMG, please call on us at (210) 485-1073, or visit Medicare.gov.


Plans accepted at Gonzaba Medical Group:

UnitedHealthcare

  • AARP Medicare Advantage SecureHorizons
  • AARP Medicare Advantage SecureHorizons Essential
  • UnitedHealthcare Dual Complete
  • UnitedHealthcare Chronic Complete

Amerigroup

  • Amerivantage Select
  • Amerivantage Classic
  • Amerivantage Dual Coordination
  • Amerivantage Dual Secure

Humana

  • Humana Gold Plus HMO
  • Humana Gold Plus SNP-DE
  • Humana Gold Plus – Diabetes and Heart

Patient Resources

How to change your Primary Care Physician (PCP)

    • Notify the Patient Advocates in the lobby/front desk area at your GMG clinic or call (210) 905-4606.
    • Call your health plan. The number is located on the back of your insurance ID card.

How to obtain a referral from your Primary Care Provider

  • Discuss the request with your PCP at your next visit.
  • Call (210) 921-3800 and let the Patient Services Representative know that you are calling to request a referral.
  • Call the Patient Advocates (210) 905-4606. They can help determine how and when to obtain referrals and authorizations for specific services.
  • Patient Advocates can also assist with pricing for specific services and help define the patient financial responsibility.

Find a Gonzaba Medical Group Contracted Specialist

  • GMG provides information to help members and prospective members identify network physicians and hospitals. The link below provides a searchable list.

GMG Preferred Provider Directory

  • Patient Advocates can provide the GMG Physician Directory / Hospital directory via print or telephonically.
  • Patient Advocates are available face-to-face at Main Clinic, Northwest Clinic and Woodlawn Clinics Monday – Friday 8:00 AM – 5:00 PM. Or reach out to them for assistance by telephone (210) 905-4606.
  • After hours, please leave a Voice Mail. Messages will be returned the next business day.

Provider Resources

How to obtain UM criteria and or find a GMG Contracted Specialist

Click here to find a Gonzaba Medical Group Specialist. To obtain UM Criteria please call GMG referral department at (210) 921-3801, Monday- Friday 8:00 AM- 5:00 PM. Information can be provided over the phone, via fax, email, or US mail.

Please be prepared to provide the following:

  • Patient’s name
  • Patient’s date of birth
  • The service description
  • The date of the service or date of the request for service

Click here to view the provider manual.

IMPORTANT AFFIRMATIVE STATEMENT

Notice for all patient Managed Care Providers/ Practitioners
& Employees who make UM decisions

Gonzaba Medical Group affirms the following:

  • UM decision making is based only on appropriateness of care and service and existence of coverage
  • The organization does not specifically reward practitioners or other individuals for issuing denials of coverage
  • Financial incentives for UM decision makers to not encourage decisions that result in underutilization
IMPARTIALITY STATEMENT – PRACTITIONERS / PROVIDERS

Gonzaba Medical Group makes this Impartiality Statement that practitioners are ensured independence and impartiality in making referral decisions with no impact on:

  1.  Hiring
  2.  Compensation
  3.  Termination
  4.  Promotion
  5.  Any other similar matters