Due to some construction in the area our phone communications have been interrupted. At the moment our phone lines are not receiving calls. If you need immediate help, please email us as indicated in the Contact Us page or use the appointment request tool that resides on the majority of our pages. Your patience and cooperation are greatly appreciated.
Here is a Blue Cross and Blue Shield Participation Update.
Note that Empire BCBS our local plan, has added a few new networks to their roster. We’re clarifying our participation status with these new plans.
Our office is not participant in the new:
- Empire BCBS Blue Priority
BCBS Blue Priority Sample Card
- Empire BCBS Pathway
- Empire BCBS Pathway Enhanced
- Empire BCBS Pathway X Enhanced
BCBS Pathway Sample Card
These plans have identification numbers preceded by YAZ, YCZ, QBP, JLB, JLF, JLC and BPR. There are other ID’s of which we have not been informed. Please consult with your insurance if you’re looking for participating providers. Please, confirm with any doctor’s office you call for an appointment, we find that the BCBS registry is often not accurate.
We ask our OUT OF NETWORK patients to pay at the time of service. Claim information will be provided to the patient for their own claim submission.
Dear Patients and referring Doctors:
We have been asked multiple times if our office offered appointments before 9am. The office will offer EXTENDED HOURS Effective Wednesday March 2018. Our doctors will alternate on a weekly basis seeing patients starting at 730am on Wednesdays. If you’re in need of an appointment earlier than 9am, this may work for you. We know our patient population is a busy one. We hope to accommodate new patients who may not be in need of urgent care, but have a hard time taking time off to see the doctor. Keep this in mind when calling for an appointment.
To ease the process of scheduling and reduce delays during your visit, please be sure to have all pertinent information at hand when you call. You should also fill our PATIENT REGISTRATION FORM online. We’ll ask for your insurance in advance of your visit. Additionally, any medical reports needed for your visit should be confirmed in our office prior to your visit before 5pm. As a last resort, you may bring them with you as we may not be able to reach other medical practices at this time.
We hope this helps with your health care and look forward to seeing you.
We want to thank everybody for your support day today year by year. We are most grateful to have great patients like yourselves who keep this practice thriving. We love to take care of you and want to be there for you for years to come. Thank you to all referring doctors for giving us the chance and opportunity to take care of your patients. We always want to give patients a way to get better when they are concerned about their health.
One more time thank you all for giving us your support and we hope you’re enjoying Thanksgiving along with your family and friends in a safe and healthy environment.
Re: Changes to our Financial Policy
As its prone to happen occasionally, we’re making changes to our financial policy. These come in response to the multiple changes to insurance policy coverage as well as the continuous shift in payment responsibility to our patients. As you as an insured party, may have become accustomed to, DEDUCTIBLES, CO-INSURANCE and CO-PAYS are commonplace and very high. To that end as of January 1st, 2018 we will require our patients to please provide a valid credit card to keep in their secure file. This credit card or debit card will be used once your claims are processed by your insurance and your responsibilities have been defined. This in turn will streamline our payment collection and billing. We hope, with your cooperation and understanding this will be a simple and painless task. We have amended our Financial policy to accommodate these clause. Additionally, a new form will be made available to you where you can fill in the pertinent information and sign your agreement.
Besides that, we have also made clearer some of our most common NON-MEDICAL fees, including our LATE CANCELLATION policy, fee for COPY OF RECORDS and LATE PAYMENT FEES. We hope once you review our amended policy you will see its simple to understand. You can follow this link for a copy. FINANCIAL POLICY
Thanks for your time,
The Billing Office
As we’re becoming more and more used to insurance company deductibles and coinsurance, we have to be even more aware of our medical expenses. Health care today is more convoluted and confusing than ever. One of the issues many patients are facing is the decision of seeing a doctor who is on staff at a hospital or hospital system as opposed to a doctor in private practice. As we have noticed in our area, many hospital systems are acquiring private practices. This is obviously to better their presence in their area and capitalize on the existing population of patients the private sector has. Health care is a business, we should all as patients understand and accept that. Now then, as we’re in the middle of receiving services, the provider (be it doctor or hospital) getting paid for said service and the insurance paying said services we need to be cautious about expenses as we would with any other goods or services we receive. Why are we mentioning this?
The truth of the matter is, when a hospital staff doctor sends a bill to the insurance he/she is billing their part plus a fee for the facility. By comparisson, when a private practice doctor bills for their services, they are billing only for their services, and normally they’re not allowed to invoice for the facility fees. As we understand it from multiple sources we have read a hospital’s invoice for facility fees when a patient is seen by their staff doctor at their office. The facility fee pertains the use of the hospital premises, staff and supplies. While this sounds like a logical fee for some, keep in mind the cost for your visit may be as much as 3 or 4 times higher than when you see a private doctor at his office.
Take a look at this article published by the ORLANDO SENTINEL:
While this article is now about 2 years old, it describes a practice and matter that is important for all of us to understand before we see a doctor. As it describes, even the same doctor who, last month was in private practice and today is a hospital staff doctor will show different fees for the same service. This may be true even if the doctor has not changed physical location. Please keep that in mind as some of these costs add up very easily and your portion will obviously rise with it. Ask about this before seeing your doctors.
This blog is in response to the following article:
LinkedIn.com Article – click here to read
In this article the writer goes over the the hurdles our healthcare providers go through to get paid for their day to day claims. Some of these hurdles are affecting our patient care adversely. In many cases even treatment plans are affected because insurance do not cover certain medications or procedures. This leaves our patient community in a healthcare limbo since the plan doesn’t “want” to pay for a service and the patient also does not want to be responsible. As the article goes on to indicate, many providers who were polled would like a single payer system. While we don’t necessarily agree with this assessment for our practice, we do believe our current healthcare hodgepodge helps only the health insurance community and not the patients or the doctors who render their services in good faith and in the best interest of our patients.
Our practice which has a large young and middle age patient population is plagued with the current HIGH DEDUCTIBLE issue. This means that our patients are responsible for the first $2000 to $5000 worth of medical services. In most instances patients don’t satisfy their deductibles before seeing one of our doctors. Many of them do not need that many services in a year. This causes a payment lag for the doctors services which in turn hurts the medical practice as a whole. Many patients are finding it hard to pay for medical services immediately once the claims have been processed.
Another issue discussed is related to the time and effort spent on trying to get the insurance plan to approve and pay for services and medications. This alone consumes several hours a week of the doctors’ and their staff. This time could be better spent caring for our patients. Add to that constant records requests and all sorts of questioning and second guessing the doctor’s judgement and yes, they go mad!
We’re interested in our patients and would like to see some progress in the healthcare machine that will put the patient’s health and the doctors’ efforts first. Our patients need care, our doctors need to be compensated for the care they provide. Web searches, deferred treatment and ER visits do not cut it. But thats the way things are going because of our current circumstances. Things need to improve.
Note that many plans require authorization for prescriptions. It seems that even commonly prescribed medications require it. Unfortunately, this way your insurance makes the process of providing you with your needed medications most time consuming. Insurance suggest that the doctor calls to obtain authorization. However, it is a most time consuming process. More often than not the doctors have several requests for pre-authorization at hand. Rather than making a call, our practice prefers to fill out a pre-authorization form. These are normally provided by your insurance and contain all information and/or questions pertinent to your particular prescription.
For that reason, if needed we ask you to obtain the required PRE-AUTHORIZATION forms from your PRESCRIPTION INSURANCE and have them forwarded to our office for the doctor’s review and fulfillment. This will allow the doctor to tend to the patients at the office as opposed to being held on the phone for several minutes a day jumping through insurance imposed processes.
Without the pre-authorization forms you will have to pay for your prescriptions out of pocket. Also, some plans have no coverage for certain medications. You’re welcome to have the insurance fax these to our main fax line:
In preparation for the forecasted blizzard, our office will be closed today. The inclement weather makes it unsafe for some of our patients and our core staff members to commute. We hope all of you stay safe, warm and cozy as this weather clears. We shall be open tomorrow, at 9am as usual. See you then.
PATIENT RESPONSIBILITY DISCLOSURE
As the new year goes on, our patients are being confronted with subtle changes in their insurance plans. Patient responsibility is newly assigned. Commonly, the new year means Deductibles reset and start again at zero. Many of our patients who had no deductibles in the previous year have them now. A large number of them are “not aware” of these changes and in turn it makes it more challenging to collect on these claims which are not paid by the plan since they represent patient’s responsibilities.
For that reason, we some time have to remind our patients that our participation with Insurance Plans does not imply you as our patient will not get a bill for services rendered during your visits or surgical procedures. Note that your Insurance Policy may have multiple ways to assign the responsibility of our fees to you. This is done through DEDUCTIBLES, COINSURANCE and COPAY. It is important to be familiar with these aspects of your plan to avoid unexpected bills and be able to manage your medical costs efficiently and effectively.
DEDUCTIBLES are assigned as per your policy to ALL SERVICES or just to CERTAIN PROCEDURES. Your insurance will not pay for your claims until the total of your deductible has been satisfied by assigning it to approved claims. These DEDUCTIBLES may range anywhere from a total of $200.00 per year to a total of $5000.00 (or more). Note, most often it will take several claims to satisfy a large deductible. As an example, if one visit claim for a patient was around $350.00 and the total deductible is more than that, then your claim for $350.00 may be payable by you, as per your plan’s provisions. Please be aware of this.
CO-INSURANCE is a percentage (%) of your total approved insurance claim which is billable to you as per your insurance policy. This varies widely through the insurance companies. A common CO-INSURANCE is 20% of the approved claim. Normally coinsurance is due after DEDUCTIBLES have been satisfied.
Additionally, a COPAY is a set amount (anywhere from $5.00 to $75.00 or more) collected from the patient at the time of the visit. This is usually stated on your insurance card. Some plans will specify different amounts for your General Doctor and for Specialists.
We hope this helps keep things clear.