Fair and Square
Given our sensitive position as an independent physician's office in today's rapidly changing healthcare climate and its unpredictable future, it's prudent to always keep accurate finances.
Most Insurances Accepted
We continue every day to advocate on your behalf by signing into contracts with new insurance companies that our patients want to use in our office, fighting for authorizations, and appealing unfair denials of payments.
Each day we submit approximately 90-120 requests for authorizations, appeal approximately 50-70 denials of previously requested items, and request fair payment on approximately 20-50 unfair denials of previously approved services.
Click the insurance options below to view more details.
Almost all. Ask us who we're partnered with and chances are they will be part of our network.
Almost all in our area,. With an HMO plan, you often have to choose a network and then, within that network, choose a primary care provider. We are currently with these networks:
- Healthcare Partners
We have low affordable rates for those without insurance or those whom we have not yet started accepting their insurance.
What Insurance Plans Do We Accept?
Prime Care Physicians participates in many insurance plans. Your insurance company can provide you with the plan’s participation list. We will submit claim forms to your insurance for all covered services. However, we do request that you pay your managed care co-payment at the time of your visit.
Prime Care Physicians also participates in some plans not listed. Check with your insurance company to see if your physician is on the plan's participation list. Any co-payments are due at the time of service.
If you are not part of a participating insurance plan, payment is expected in full at the time of the visit. We will, however, bill your insurance as a courtesy to you.
Any services that you receive outside the physician’s office (such as hospital admission, ultrasound or lab test) will be billed to your insurance company directly.
After we bill your insurance company, you may receive a statement from us for amounts that aren’t covered. We appreciate your prompt payment of these amounts. If you need assistance regarding your bill, please contact our billing office staff.
Know the requirements of your managed care plan. Many plans require a referral for visits to offices other than those of your primary care physician. Some plans also require prior authorization for certain diagnostic or surgical procedures, such as MRIs, CAT scans and bone density scans. Without an appropriate referral, benefits will be denied. If you arrive at the specialist's office without the appropriate referral, you will be required to sign a waiver accepting responsibility for payment for uncovered services.
Our physicians are participating Medicare providers. We will submit claims to Medicare and agree to have them pay us directly. If you don’t have secondary coverage, you will be responsible for any services not covered by Medicare, your deductible, and your coinsurance payments.
Certain procedures or services may not be covered by your insurance. Our staff will request that you sign a waiver accepting responsibility for payment.
Managed Care Referrals
Many plans require a referral for visits for visits to offices other than those of your primary care physician. Some plans also require prior authorization for certain diagnostic or surgical procedures, such as MRIs, CAT scans and bone densitometry scans. Without an appropriate referral, benefits will be denied. If you arrive at the specialist’s office without the appropriate referral, we will request that you sign a waiver accepting responsibility for payment for uncovered services.
Release Of Information
You must update and sign a new Release of Information form annually or whenever your insurance status changes. Without this, we cannot submit insurance claims to your carrier.
If you are unable to pay the full balance at the time of your visit, you can make payment arrangements with our office staff. We accept Visa, MasterCard, Discover, American Express and most debit cards.
Patient Consent to Use Health Care Information
We ask you to complete and sign a Patient Consent to Use Health Care Information form annually. Your consent gives us permission to submit insurance claims to your carrier. This consent is essential if we are to submit claims for you.
Feel free to ask our staff or the site manager any questions about our services. Because your satisfaction is important to us, we’ve made comment cards available in all of our offices and on this website. Please let us know how we can serve you better.
13425 Ventura Blvd., Suite 102
Sherman Oaks, CA 91423
Prime Care Physicians is a primary care medical practice started in response to a need for quality primary care in the local community. Our goal is to preserve the quality of the personal relationship between patient and doctor, prevent disease, and help guide our patients through the medical maze of specialists and consultations should a medical concern arise. Our long term goals are to expand in geographic locations served and services available.