Provider Patient

HEALTH SYSTEM CHARGES

Before seeking care in one of our clinics, please check with your insurance provider to ensure the clinic and doctor you are visiting participates with your insurance and that your plan is considered in-network. We encourage all patients to understand their coverage, benefits, and out-of-pocket costs through their health insurance carrier before making a visit with one of our physicians.

We will submit charges for your appointment(s) to your insurance carrier. Once your insurance has processed your claims you will receive a statement if there is a balance. You might receive more than one bill depending on where you were seen and the services provided.

Insurance Types Accepted

  • Contracted insurance plans
  • Medicare
  • Medicaid
  • Tricare/Champus
  • HMOs and PPOs
  • Other insurance, such as motor vehicle and worker’s compensation

Your first statement will list detailed charges. Following monthly statements will summarize any balance as a previous balance due. We recommend that all patients keep a copy of their initial statement for their records.

Coverage of Preventative Visits and Annual Wellness Exams 

Preventive care promotes a healthy lifestyle to prevent illnesses in the early stages. This exam is prevention focused, not problem focused.  If you have a new health problem or other diagnosis that needs to be addressed during your preventive exam, the portion of your visit related to the treatment of your diagnosis would apply toward your deductible and co-insurance medical benefits.

For appointments that are spent caring for existing concerns, the visit will be billed as a medical treatment rather than a preventative appointment. Having a clear idea of your concerns before you make your appointment and knowing which services are covered under your health plan will help to avoid any confusion.

Routine Preventive Care May Include:

  • Past medical, social and family history
  • Complete physical exam and review of body systems
  • Review of medications
  • Immunizations
  • Counseling/anticipatory guidance/risk factor reduction interventions
  • Review of age/gender appropriate screening tests

For questions regarding your insurance, review your summary of benefits prior to your preventative exam or call your insurance carrier for your benefit information.

Out-of-Pocket Costs

For hospital-based clinics, most insurance providers process claims under the patient’s outpatient hospital benefits. Depending on your health insurance benefits, this may result in increased out of pocket costs, either through an increased copay, coinsurance or deductible amount. We recommend patients ask their insurance company about cost differences between the coverage of services in a hospital-based clinic versus those in a freestanding clinic.