Our doctors participate with most major insurance companies, as well as Medicare and Medicaid. Please contact our office to inquire.
You may be responsible for a deductible, co-insurance, or a copayment.
The deductible refers to the amount of money that the insured would need to pay before any benefits from the health insurance policy can be used. This is usually a yearly amount so when the policy starts again, usually after a year, the deductible would be in effect again. Some services, like doctor visits, may be available without meeting the deductible first. Usually there are separate individual deductible amounts and total family deductible amounts.
This is usually a percentage amount that is the insured's responsibility. A common co-insurance split is 80/20. This means that the insurance company will pay 80% of the procedure and the insured is required to pay the other 20%.
The co-payment is a fixed amount that the insured is required to pay at the time of service. It is usually required for basic doctor visits and when purchasing prescription medications.
Since our doctors participate with most insurance plans they should be in your network, but if they are not, out-of-network benefits can be used to pay for the services rendered.
In-network benefits are provided by a physician or provider who is listed in the network's provider directory. The providers listed in a network directory have contracted with the network to provide services.
Out-of-network services are those services provided by physicians or providers that are not listed in the network's provider directory, or have not made a specific agreement with the network to provide services for the network.
So, why would a patient go out of network? There are some very good reasons. If you or a loved one is facing a serious illness, you may want more options as well as services other than are available in your network. Sometimes that means finding a specialist with a special skill set who is not a part of your network.
We encourage all of our patients to call their insurance company or access the company's website to inquire about their benefits. You can also contact our financial specialist with any questions, and we will be able assist you and reach out to your company on your behalf.
