Have There Been Any Changes to Your Insurance?

This question is asked every time you go to the doctors office. In the future, you may consider mentioning any insurance changes (modifications or a different plan, new coverage, no coverage, etc …) when making the appointment as well as when you check-in. This may help avoid problems down-the-line with billing and/or disconnects about who is responsible for what. There are usually extra phone calls that need to be made as well as extra time spent by both patients and providers in order to verify everything.

The patient is responsible for \”trying to know\” what is covered and what is not.

All our office can do is recommend/suggest medical care. Insurance plans change minute by minute which makes it impossible for us to know which plans give what coverage. The patient is responsible for \”trying to know\” what is covered and what is not. All we know is physicals are 100% covered*. Ultimately, we are just trying to recommend the best treatment for the patient based on what they need right then and there.

Our office can give a general \”ball park\” idea of what a prescription medication might cost. In some cases, we can give a general estimate of what a procedure or imaging study (X-ray – MRI) might cost but we can not be exact. We encourage people to call the facility we are setting them up with – which we always send people to the lowest cost facilities around for the same test. Rather than sending people to a hospital affiliated imaging place we will send them to an outpatient facility, non-affiliated place because they will provide the same services. The results will essentially be read by the same radiologist for sometimes 50% less.

*Physicals are 100% covered… keeping in mind, labs MAY NOT be considered preventive. While the physicians services are covered at 100%, many insurances, including Medicare, DO NOT PAY for lab services as a screening exam. They will charge the patient.