Insurance Information
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.
Medicare
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.
Non-Covered Services
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.
Payment Arrangements
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.