Have a question?

Healthy Kids. Happy Parents.
Member Resources.YOUR QUESTIONS ANSWERED.

Thanks for choosing a pediatrician with CPMG, where our only focus is health care for kids. Below you’ll find answers to some of the most commonly asked questions we get from our members.


1. Do you provide case management services?

Yes, we do. Please call our Customer Service Department at 1-877-276-4543 to receive case management services from one of our nurses.


2. What is an authorization and how does the authorization process work?

If your child is referred for a medical service the referring doctor will send a request for authorization to Children’s Physicians Medical Group (CPMG). The request is reviewed by CPMG clinical staff.

You and your doctor will be notified by mail of any decision, whether authorized or denied. If a denial of coverage is issued, you have the right to appeal that decision with your health plan. You will receive a letter with information on how to appeal the denial.

Any policies or clinical criteria used to make an authorization decision are available upon request from CPMG. If you have any questions about this process or your authorization request, please contact us.


3. What services require prior authorization?
  • Acupuncture
  • Chiropractic
  • Cochlear Implants and supplies
  • CT Scans (only when diagnosis is headache)
  • Dental Anesthesia
  • Durable Medical Equipment (DME)
  • Genetic Testing
  • Hearing Aids and supplies
  • Home Health Services
  • Infusion
  • Injectable Medications  
  • Inpatient Admissions
  • MRI (only when diagnosis is headache)
  • Nutrition/Weight Management
  • Occupational Therapy
  • Orthotics / Prosthetics
  • Out of Network Services
  • PET Scans
  • Physical Therapy
  • Speech Therapy
  • Transplants

4. How is an authorization decision made?

Authorization decisions are based on several things:

  • Clinical information provided
  • Benefits and coverage of your health insurance plan
  • Your health plan’s medical policies
  • Use of the CPMG network of providers

Because it might be a concern, please know that CPMG utilization-management decision making is based only on appropriateness of care, services and existence of coverage. The providers or other individuals conducting utilization review for coverage or services are not compensated for denials and/or encouraged for barriers to care or services. Incentives are not used to reward inappropriate restriction of care.

Should you wish to see our policy statement, a copy of the Affirmative Statement can be found by clicking here.


5. How do I contact my doctor after hours or on weekends?

Call your doctor’s office first, anytime, day or night. Your doctor or nurse will give you medical advice and, if needed, send you to the right place to receive the care your child needs.


6. Which Urgent Care should I go to?

If advised to take your child to urgent care, you have many choices covered by your insurance. You can easily look up a conveniently located urgent care site here.


7. How do I know if a doctor is in network?

Ask your pediatrician first. You can also search by doctor name or specialty on our “Find a Doctor” page.


8. How do I find a speech, occupational or physical therapy provider?

FREE services are available through your school district. Click here for contact information. Rady Children’s Hospital-San Diego offers pediatric therapy services in several locations. For occupational or physical therapy, call (858) 966-5829. For speech therapy, call (858) 966-5838. Additional contracted providers can be found here.


9. What if I want a second opinion?

Member-requested second opinions are authorized by your health plan. You may contact them through the member services phone number on your insurance card for assistance.


10. How do I file a complaint?

Complaints and grievances are handled by your health plan. Contact the member services phone number on your insurance card for assistance.


11. Member Bill of Rights

Patient Bill of Rights.pdf



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We are very pleased with the care our children have received since we joined CPMG in May of ’09. (The) Doctors are very knowledgeable, (and) take their time to listen and the office staff is awesome at your El Cajon Office. We hope to keep this relationship until our kids are grown! Thank You!

DONALD R.

Dr. Barbadillo was my doctor when I was a baby and now that I have a baby she is her doctor. I love her clinic, it’s always neat and clean. Just wanted to say thank you!

ANONYMOUS

Dr. Juarez is very knowledgeable and helpful. Great pediatrician. Thank you!

SUE P.

The doctors at Children’s Hospital and especially Dr. Stephanie Powell are very caring. They are also very professional.

MARIA

I have never felt so informed before as I have since my 12 year old and 10 week old are with Dr. Pamela Atienza and CPMG.

ARIANA VALDOVINOS

As a member of CPMG I like that I have a contact that addresses my needs and follows up with me.

M.I.

My 17 year old daughter will not go to any other pediatrician other than Dr. Leslie McCormick. Both my daughters have been with her since babies. My 17 year old will be graduating this year and because of the personal contact Dr. McCormick has with her my daughter has decided to become a doctor and go to medical school. Dr. McCormick has been a great influence for her.

N. SCOTT

Dr. Pring has been a great doctor and helpful for my brother. She’s wonderful!

ANONYMOUS

I have Dr. Stuart Cohen as my kids’ pediatrician and I think he is a very good doctor.

ANONYMOUS

My husband and I would like to let you know that we enjoy our children’s doctor. She has treated our children with the utmost respect, and has given us as parents, the assurance that she is available to see and answer questions about our children and their health.

REBEKAH S.

I chose CPMG because they make you feel like you are amongst family and their group gives me access to Rady Children’s Hospital for the specialists. Our pediatrician gives us personal attention and the office is very warm and friendly. It is so important that my children feel comfortable with their physician.

SHANNON S.

I joined CPMG because I wanted my children to be part of Dr. Rafael Garcia’s office. He is great, he listens and understands and most of all he goes beyond the call. I love CPMG and Dr. Rafael Garcia.

ANONYMOUS

The pediatricians for CPMG are dynamic. My kids have been with Dr. Grant for 6 years. The customer service is excellent at CPMG.

M. FULLER

This year our family experienced a frightening situation when we had to rush our 1 year old son to the Emergency Room at Rady Children’s Hospital with a respiratory distress problem. We are grateful and impressed with the immediate treatment and care that everyone provided our son with. Most impressive and caring is his pediatrician Dr. Christian Archambault whom monitored his health problems and took the time from his busy schedule to drive in a rain storm to visit him at the Hospital. Thank you to the staff of Rady Children’s Hospital for your professionalism and care, and a special thank you to Dr. Archambault for being a partner with our family in raising our children as healthy as possible.

K. TOPETE

We chose CPMG because of the access to Rady Children’s Hospital. Our pediatrician is great and she really seems to care about my son and his needs. He is now a teenager and she helps with making him realize he has a say in his medical care and responsibility.

ANDREA T.

I started 25 years ago with my daughter seeing Dr. Farron until she retired. When my son way young, then we went to Dr. Cordoba with my son who is 19 now. He was very upset he was too old now to see him. But now my grandson who is 8 years old started with Dr. Cordoba and now he adores Dr. Cordoba. Thank you for years of wonderful care.

THE YANCEYS