We participate in most insurance plans including Medicare. We are happy to bill your insurance company for you but we need a copy of your insurance card at the time of service in order to do so. If the correct insurance information is not given to us, it may be necessary to bill you for the services rendered.
If a copay is required by your insurance it is to be paid prior to seeing our provider. We are required by your insurance to collect the copay at the time of service. Remember insurance companies often apply different copay amounts for specialists. Please come prepared to pay this amount. Many insurance policies have a yearly deductible that must be met by the patient before the insurance will pay their percentage. Any unmet deductibles must be paid at the time of service for our surgical appointments. Our authorization personnel will be contacting you prior to your surgery appointment to discuss this with you.
Additionally, many insurance plans have “co-insurance.” For example, after your copay is paid, and after your deductible is met, you may still be liable for a percentage of the charge if your plan has a co-insurance. Your insurance company may only pay 70-80% of the remaining balance, leaving you responsible for the other 20-30%. Check with your insurance company or your employer to see if your plan has a co-insurance in addition to a copay and deductible.
Office Visit vs. Procedures
An office visit is defined as the examination and consultation with our provider.
Any procedures performed in our office carry additional charges above the office visit charge. It is the patient’s responsibility to inquire about the additional cost before the procedures are performed.
Some health insurance policies allow you to make an appointment directly with a specialist while others require a referral from your primary care physician. Often these referrals have a number on them that your insurance company requires be attached to your claim. Other insurance companies only require a note from your primary care physician. If you have questions regarding referral requirements, please contact your insurance carrier. Individual policies vary greatly.