Changing rheumatologists wasn’t your idea. We’ll make it easy.

We are in network with Anthem Blue Cross PPO and EPO plans on the full Prudent Buyer network. We see Anthem Blue Cross HMO members through three medical groups: Greater Tri-Cities IPA, UCSD PHSO, and Sharp Community Medical Group, with a referral from your primary care doctor. We are also in network with Anthem Medicare Advantage PPO plans, and see Anthem Medicare Advantage HMO members through our partner medical groups with a referral. We are not in network with the Anthem Select PPO (a narrower network) or Anthem Pathway plans sold through Covered California.

Possibly, for a while. California law lets patients with a serious chronic condition — which includes most people on ongoing rheumatology treatment — ask their health plan for "continuity of care," meaning continued in-network coverage with a doctor who has left the network, for a limited period (up to 12 months for a serious chronic condition). You have to request it, and Anthem decides each request individually. Call the member services number on your Anthem card and ask for a continuity of care request. If you would rather transfer now, or when that period ends, we will coordinate the handoff.

Contact us as early as you can — call (760) 891-4687 or email info@synergyrheum.com — and tell us your medication, your dosing interval, and the date of your last infusion. Patients who are mid-treatment are scheduled as a priority. We request your records, see you for a new patient visit, submit the new prior authorization, and book your first infusion here before your next dose is due. Our goal is no gaps in care.

Usually not. A prior authorization is generally tied to the prescribing doctor and the place the medication is given, so a new one has to be submitted when you change practices. Our office handles that submission for you. It is the step that takes the most time, which is why we ask infusion patients to reach out before their next dose is due rather than after.

Anthem HMO members need a referral from their primary care doctor, and that doctor must belong to a medical group we work with: Greater Tri-Cities IPA, UCSD PHSO (UC San Diego Health’s physician network), or Sharp Community Medical Group. If your plan is Anthem Priority Select HMO, note that Sharp Community Medical Group does not participate in that network — choose a primary care doctor with Greater Tri-Cities IPA or UCSD PHSO if you would like to be referred to us. Once the referral is in place, call us to schedule.

If your current treatment is working, the plan is usually to continue it. We can access records from the major health systems in the area, so repeat testing is rarely needed. Screening tests such as tuberculosis or hepatitis B are repeated only when medically indicated.

Synergy Rheumatology & Wellness is at 6120 Paseo Del Norte, Ste L2, Carlsbad, CA 92011. Our patients come from across North County San Diego, including Carlsbad, Oceanside, Vista, San Marcos, Encinitas, Escondido, and Del Mar. Infusions are given in our office by registered nurses, with the rheumatologist on-site.

Yes. We manage rituximab therapy — deciding on dosing and timing, monitoring labs, and handling the prior authorization — but the infusion itself is given at an off-site infusion center we coordinate with, not in our office. Let us know when your last dose was so we can plan the next one.

Many of the patients who contact us about this are affected by it. Scripps Health and Anthem Blue Cross have been negotiating a new contract. According to both organizations, Anthem HMO members assigned to Scripps physicians are being moved to other in-network doctors starting October 1, 2026, and most other commercial Anthem members (such as PPO and EPO) keep in-network access to Scripps through December 31, 2026. Negotiations may still change this, so check the official pages for the current status. Synergy Rheumatology is an independent practice and is not affiliated with either organization.

• Anthem’s update on Scripps Health
• Scripps Health’s update on Anthem