Insurance often does not cover 100% of costs. You may be responsible for:
Copayments– a fixed amount you pay for a service, such as $25 for an office visit. This is due at the time of the visit.
Deductibles– the amount you must pay out-of-pocket each year before your insurance starts paying for covered services. If you believe your deductible was met and you receive a bill, please contact your insurance.
Coinsurance- the percentage of costs you pay after meeting your deductible (for example, 20%), while insurance pays the rest.
Non-Covered Services- when an insurance company refuses to pay for a service because it is not included in the patient’s benefit plan or fails to meet specific coverage criteria.
Prior Authorization- approval from your insurance company before receiving certain services to ensure they will be covered.
Out-of-Network Charges– when providers do not have a contract with your specific insurance company (or plan). This may mean higher costs for you or no coverage at all. To be sure we are “in-network” with your insurance company (or specific plan), please contact your insurance company with our Tax ID 202851929.
PCP Selection– some insurances require you to select a Primary Care Physician (PCP). Please make sure you select a provider from our office.
Well Visit with a Sick Visit– the combination of a routine physical (well visit) with a problem discovered during the well visit (or if you choose to discuss additional complaints during the well visit) may result in additional charges passed on by your insurance company. Payment responsibility varies widely by insurance company, and it is important for you to understand your plan’s policy regarding cost-sharing when visits are combined.