Q: Will you bill my insurance? A: Yes, as a courtesy to all our patients we bill all insurance companies with a few exceptions like Tri Care or VA. If you are unsure, please don't hesitate to call our office, or send an email through our secure Contact Us page. Please note that usual and customary adjustments are reserved only for contracted insurance companies. Remember that the insurance policy you have is a relationship between you and your insurance company where the physician is simply a messenger of charges incurred. All charges are the ultimate responsibility of the patient.
Q: I have double coverage. Will you bill my secondary insurance? A: Yes, as a courtesy to all our patients we bill most secondary and even tertiary insurance companies with a few exceptions like Tri Care, International Insurance and Travel Plans.
Q: What insurance policies do you accept? A: We will bill nearly all insurance companies (see above). However, check out our insurance page to see which companies we have contracts with.
Q: How long does it take my insurance to pay? A: It can take anywhere from 30 days to 6 months for an insurance carrier to respond to your claim. Some claims will take longer if they are waiting on information from you or the provider, or if the claim has not reached the carrier (this can happen through computer malfunctions). If the provider is appealing a claim it can take up to a year to resolve the issue.
Q: Why did it take so long for my insurance to pay?
A: Most insurances will have paid or responded to your claim within 30 to 45 days.Some insurances may take up to 3 - 6 months to respond to a claim depending on certain circumstances, such as: lack of information from the patient or provider, lost claims that did not make it to the insurance company (at no fault of either your insurance or the provider), or the claim has been mailed in by paper instead of computerized billing.If a claim is appealed it can take up to a year to resolve, as the insurance company and the provider's office work together.
Q: Can I have a different co-pay for my Office Visit, than my Procedures or Labs?
A: Depending on your insurance plan you may have a flat co-pay for your office visit and an additional percentage for your procedures or labs.
Q: Do I need pre-authorization?
A: This depends on your insurance plan. We encourage you to contact your insurance company for this information.It is always good to know ahead of time if you need your doctor to send a pre-authorization request to your insurance company.The only way your physician will know if you need one is for you to inform him/her.
Q: What is a "non covered" service?
A: A non-covered service is a service that your insurance company will not cover as stated in your plan booklet.In certain circumstances this may include experimental procedures or labs. The patient may be presented and asked to sign a waiver letting them know they will be responsible for payment of these services.
Q: My insurance company says you overcharged me. Why are my fees different than what my insurance says they should be?
A: Each clinic has their own fee schedule based on national averages of charges for the area they are in. They must charge the same price to all insurance companies. Insurances have “allowable” amounts that differ between companys and plans. These allowables are reduced rates that a provider has to adjust off if they are contracted with a certain insurance company.If they are not contracted, then the difference between the allowable and the fee schedule amount may be passed along to the patient.
Q: It says on my fee slip that I was seen for a physical, but I discussed other things with the doctor. Can you change the code on my visit so my insurance company will pay?
A: The billing department in any doctors office, hospital, or clinic can only send bills to the insurance company that can be supported by chart notes written by the doctor.These notes cannot be changed once they are dictated and placed in the patient's chart as they are legal documents.
