In 2007, the City and County of San Francisco created a state-approved Medical Provider Network (CCSF MPN) to provide employees who have experienced a work-related injury. At the time, the medical network covered all CCSF departments except the San Francisco Municipal Transit Authority (SFMTA). On July 25, 2013, the state Division of Workers’ Compensation approved a modification to the CCSF MPN to expand the network to include the San Francisco Municipal Transit Authority and the employees of the San Francisco Community College District. This change is effective as of September 3, 2013 for SFMTA. The effective date for the San Francisco Community College District is pending. The goal of the CCSF MPN is to provide the employees of the City & County of San Francisco and the San Francisco Community College District with a single portal to accessing prompt effective medical care with physicians and providers who understand the complexities of the California workers’ compensation system. Many treatments common to occupational injuries and illnesses are pre-approved with the physicians within the network. With this partnership, we can reduce unnecessary work disability.
What is a Medical Provider Network?
A Medical Provider Network (MPN) is a group of health care providers (physicians and other types of providers) set up by an insurer or self-insured employer and approved by the Division of Workers' Compensation's Administrative Director to treat workers injured on the job. Each MPN must include a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine. MPNs must meet access to care standards for common occupational injuries and work-related illnesses. Further, the regulations require MPN providers to use medical treatment guidelines adopted by the State Division of Workers’ Compensation.
How do employees find a provider within the CCSF MPN?
The assigned claims adjuster is responsible for setting up the initial appointment with a CCSF MPN physician unless the employee has properly “pre-designated” a treating physician. After that visit, the employee has the option of choosing a different physician within the network.
The CCSF MPN medical provider list can also be accessed at the following website: www.talispoint.com/intermed/ccsfmpn, where employees may search for providers near their workplace or residence by specialty or by provider name. While every effort is made to maintain accurate information, provider information is subject to change. Please contact the Medical Access Assistant at (844) 875-8666 or email her at firstname.lastname@example.org if you require assistance locating providers or if you have any questions regarding this provider listing or to report any inaccuracies in this provider listing.
Employees may also request a regional listing of providers within their geographic location from the MPN Contact below. At minimum, the regional listing must include a list of all MPN providers within 15 miles of the employee’s workplace or residence, or within the county where the employee lives or works. Employees may choose which list to receive.
Medical Provider Network (MPN) Notice to Employees
Who can I contact if I have questions about the CCSF MPN? The CCSF MPN Contact person is:
Medical Access Assistant
This MPN contact listed in this notification can help answer questions about the CCSF MPN and will help you obtain a regional list of all MPN doctors in your area if needed. Also, while every effort is made to maintain accurate information, provider information is subject to change. Please contact the MPN contact to report any inaccuracies in this provider listing.
Medical Mileage Form
If you have to travel to get treatment for your work injury, you are entitled to re-payment of your travel costs. The mileage rate changes annually based on the Internal Revenue Service (IRS) published mileage reimbursement rate.
Mileage for reasonable travel to the pharmacy, parking, bridge tolls, public transportation and other travel related costs is included.
This form is fillable and will automatically calculate the totals, making it easier for the claims adjuster to read and approve for payment.
Other helpful links:
The Division of Workers’ Compensation’s website contains additional information designed for the various participants in the system, from the adopted regulations governing employers and insurers to FAQs.
Go to: www.dir.ca.gov/dwc