Please familiarize yourself with your particular plans and benefits. If your
coverage or your copay changes, it is your
responsibility to let us know before we render service. Some
insurance companies structure their reimbursement based on a deductible, please
take note of your specific coverage.
By participating with your insurance company, it means that we have signed a
contractual agreement to accept a lower than normal fee for our services as
payment in full.
Your co-pay or co-insurance is a significant part of
that payment. Your co-payment or co-insurance is part of the total
reimbursement for our services.
The payment we receive from the insurance company is the difference between
your co-payment and the discounted fee for that service. We are not paid more
because you have a higher co-payment. Simply stated, your insurance just pays
less.
Unfortunately many insurance companies do not allow us to provide all
services that are available in our practice due to their contractual
arrangements with laboratories, specialists or hospital services. You may be
able to avail yourself of services that are not covered by your insurance
company at an additional fee. (ie: cosmetic services etc.)
Our participation in Managed Care Programs is constantly under review. lf at
some time, we determine that the rate of our reimbursement from a particular
Managed Care Program is incompatible with quality patient care and the viability
of the practice, we reserve the right to withdraw from participating in that
plan. ln such a case, we will give our impacted patients adequate notice
(approximately three months in advance) so that they may select a new plan or
find another physician.
Because insurance reimbursements to primary care practitioners and
specialists continue to plummet relative to the cost of living many doctors are
leaving Managed Care Plans. For this reason, we encourage you to consider
insurance plans offered through your employer that will reimburse you to some
degree if you see a physician out of their network.
