Accepted Insurance

We accept most major insurances.

  • Medicare traditional and most Medicare advantage plans
  • Majority of commercial insurances
  • Selected HMO plans through Advocate physician health organizations including Blue Cross HMO, BlueCare direct, Humana HMO, United health care HMO
  • Site selected for HMO plan would be 464 and 600
  • We urge you to check with your insurance company regarding our participation. With new insurance plans coming up all the time, that is the only way to make certain of our participation.

Insurance verification

Please ensure you carry your latest information with you during the office visit.
  • All patients are required to bring their insurance card with them to every office visit
  • If you do not have required documentation you may be asked to reschedule your appointment or pay in full at the time of service

Co-pays

  • Co-pays are due at the time of visit
  • We accept VISA and MasterCard for payments over $10There is a service charge of 2.5% for all credit card transactions

Your Insurance Benefits

  • Kindly know your benefits before your appointment
  • For example yearly physicals, labs screening tests like colonoscopy EKG Pap smears etc.,
  • Sick visit and well visits cannot be combined
  • We are unable to tell you what is covered or not at the time of the visit. Your insurance as a contract between you and your insurance company.

Referrals and prior Authorizations

Some insurance companies frequently deny payment for certain non-formulary prescriptions. Our staff will make every effort for “prior authorization” on your behalf so that you can receive your medication. This process may take a few weeks. You are invited to inquire the status of your prior authorization with us if your pharmacy refuses to dispense your medication. An office visit may be required to address prior authorization concerns.

Majority of insurance require your doctor to obtain prior authorization for diagnostic tests like CT scan, MRI, stress tests, nuclear imaging and some others. This could sometimes take a few weeks. You will need an office visit before any of these tests can be ordered.

HMO members

  • Prior authorization is needed for every test and service including specialist referrals, radiology tests and procedures
  • When we refer you to a specialist they should be able to provide you with referrals regarding testing that they are ordering or condition that they are treating .
  • If the consultants want you to see another kind of specialist you will be asked to make a followup appointment with us before we can process that referral
  • Referrals done are valid for a finite period of time only
  • If testing and followup is not completed during that time and new referrals need to be processed another visit will be warranted
  • If you fail to obtain referrals, no retro referrals can be processed., You will then be responsible for significant out of pocket expenses.
  • We will contact you once referral is processed.
  • Kindly allow us 5-7 business days to process them since it is a very time-consuming process. If we do not call you within that time kindly check back with our office regarding the delay.

Billing

  • We contract an outside company to do a billing
  • we can provide a number to contact them directly about your claim if you have any questions
  • Please know your benefits before scheduling a visit
  • We cannot order diagnostic testing during wellness visits other than routine labs, Pap, EKG and vaccinations
  • If you have multiple health concerns a separate visit would be the best solution.