sanfranciscohealthplan policy updates
Track new and updated sanfranciscohealthplan policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Prior Authorization | Sanfranciscohealthplan | Administrative | — | Modified | Dec 18, 2025 |
| Discharge Planning | Sanfranciscohealthplan | Administrative | — | Modified | Dec 1, 2025 |
| Durable Medical Equipment (DME) Coverage Criteria | Sanfranciscohealthplan | Clinical | Durable Medical Equipment (DME) | Modified | Nov 20, 2025 |
| Buprenorphine prescribing after DATA-Waiver removal | Sanfranciscohealthplan | Clinical | Psychiatry/Behavioral Health | Modified | Jan 12, 2023 |
| Primary Care Provider Site Reviews: Facility Site Review and Medical Record Review | Sanfranciscohealthplan | Administrative | — | Modified | Jul 1, 2022 |
| Drug and Hazardous Substance Disposal | Sanfranciscohealthplan | Administrative | — | Modified | Jan 1, 2022 |
| Patient Confidentiality and Record Release | Sanfranciscohealthplan | Administrative | — | Modified | Jan 1, 2022 |
| Personnel Training: Informed Consent and Human Sterilization Consent | Sanfranciscohealthplan | Administrative | — | Modified | Jan 1, 2022 |
| 837 Professional Claims/Encounters HIPAA Companion Guide | Sanfranciscohealthplan | Administrative | — | Modified | May 14, 2021 |
| DHCS All Plan Letter 21-002 — post-payment recovery and Other Health Coverage (OHC) reporting | Sanfranciscohealthplan | Administrative | — | Modified | Jan 1, 2021 |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.