Where can I go to get healthcare?

Valley Health Plan Network Health Centers Valley Health Plan has a number of health centers that provide the health care services you need. As a Valley Health Plan (VHP) member you choose a VHP doctor. These doctors are located throughout Santa Clara County. These visits are covered 100% through VHP. To request a list of our health centers and a Primary Care Physician you can choose, call Member Services at 408.885.4760 or 888.421.8444 (toll free) or visit the VHP Web site at www.valleyhealthplan.org.

What Hospital Do I Go To? As a Valley Health Plan member your hospital is Santa Clara Valley Medical Center (SCVMC). SCVMC is located at 751 S. Bascom Avenue in San José.

What About An Emergency…What Do I Do? In the case of an emergency, call 911. Go to the Santa Clara Valley Medical Center Emergency Room for services. If you cannot safely come to SCVMC, go to the nearest emergency room.

How to choose a doctor

A Doctor For You Your doctor or Primary Care Physician (PCP) plays a key role in your health care and will be your regular, personal doctor. Your doctor may refer you to other doctors/specialists when necessary.

How Do I Choose or Change My Doctor? You can choose your own doctor (PCP) from within the VHP Network. If you do not choose a doctor, you will be assigned one by VHP. You can change your doctor at anytime by calling VHP Member Services at 408.885.4760 or 888.421.8444 (toll free). Visit the VHP Web site at www.valleyhealthplan.org to view the Primary Care Physician List.

Who to call

Member Services At Valley Health Plan Call VHP Member Services at 408.885.4760 or 888.421.8444 (toll free) if you have any questions about your health plan benefits or if you need assistance with any other health plan matter.

Need To Make An Appointment? For an appointment with a PCP who practices at a Valley Health Center location, call Valley Connection at 888.334.1000 (toll-free).  For all other PCPs, call the appointment phone number listed for their clinic, these phone numbers are available on the PCP list. 

Need Medical Advice? Call Valley Connection at 888.334.1000 to speak with an Advice Nurse. Advice Nurses are available 24 hours a day, seven days a week. They can give you medical advice and direct you to the care you need. 

Member Grievances

At Valley Health Plan (VHP) we take pride in being a member focused health plan.  We suggest that you allow our Member Services Department to assist you in resolving your concerns. You may call a VHP Member Services Representative at 408.885.4760 or 888.421.8444, they are available Monday through Friday between 9:00am - 5:00pm.  You may request that a formal Grievance be filed on your behalf or you can complete a Grievance form and submit it to VHP.  Grievance forms are available through VHP, at your and at your provider's office.  Send your Grievance to Valley Health Plan, Attention: Grievance Department, 2325 Enborg Lane, Suite 290, San Jose, CA 95128.  Alternatively, you may also submit your Grievance online.

Department of Managed Health Care (DMHC) Consumer Help-Line

"The California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should first telephone your health plan at 408.885.4760 or 888.421.8444 and use your health plan's grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you.

If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services.

The department also has a toll-free telephone number (888.HMO.2219) and a TDD line (877.688.9891) for the hearing and speech impaired. The department's Internet Web site http://www.hmohelp.ca.gov has complaint forms, IMR application forms and instructions online."

Call 911 in the case of an emergency.