A copay is a flat dollar amount that is generally owed for all Office Visits. With certain insurance policies diagnostic and/or surgical procedures can be subject to a copay as well.
A deductible is the dollar amount that you (the patient) will owe each policy year before your insurance pays at any percentage.
Coinsurance is the percentage your insurance will cover once you have met your deductible. Some policies don’t have a coinsurance. These policies pay 100% once your deductible is met.
Maximum out of pocket is the maximum amount you will pay in a policy year before your insurance will cover you at 100%. Some policies Include copays and/or deductibles in your maximum out of pocket and others do not. Please contact your individual insurance policy if you are unsure about your coverage.
A charge is the dollar amount we submit to the insurance company. Insurance company’s generally approves of a smaller dollar amount than what physicians charge. The patient responsibility is what your insurance company approves.
A credit can be a patient payment, insurance payment or insurances adjustment. Insurance adjustments are generally made to adjust off the difference between the amount charged to insurance and the amount the insurance company approves of for that charge.
The total balance includes all charges not paid yet. This includes charges to be paid by insurance and/or patient. The patient balance is strictly what the patient owes at the time of the bill.
Insurance Pending means that the charges have been sent to insurance but they have not yet processed. The insurance will pay and/or adjust this balance according to your cost share (deductible, coinsurance and maximum out of pocket).
If you gave us a secondary insurance card but it was not billed, please feel free to reach out to us and we will gladly send the claim. If you did not inform us of your secondary insurance while in office, you can call us with the information of your secondary insurance and (as long as it isn’t passed timely filing limits) we can submit the claim. Note: Secondary insurance policies may or may not cover everything the primary insurance does not. You may still get a bill once both insurance plans process.
Once your insurance company processes your claims they send us an explanation of benefits. We post this to your account according to how the insurance processed your claim (payments, deductible, coinsurance, copays). Therefore, if you disagree with these amounts we urge you to call your insurance company. If they inform you it was an error in their processing they will reprocess the claim for you. If you have a discrepancy with the insurance policy we sent your claims to or who we listed as policy holder, please feel free to contact us.
We can only quote you the benefits that your insurance company has quoted us. We cannot guarantee the benefits that your insurance company’s online portal, automated phone system or phone representative has quoted. Please refer back to your insurance contract if you feel these benefits are incorrect.
The leg ultrasounds we perform are diagnostic. It is a “test” that helps us to diagnose and treat a patient.
According to insurance companies, the laser ablations, phlebectomies and sclerotherapy injections are considered in office/outpatient surgery.
The consult is free. If you are a candidate, we may offer to go forward with your Mapping the same day. The Mapping consists of your initial office visit along with a diagnostic ultrasound of your legs. This will tell us what treatment, and approximately how many treatments are needed. If you decided to stay same day for the Mapping, that would be subject to your insurance cost share.
Every patient is different but we will be able to give you an estimate once you have an ultrasound.
Most insurance policies consider the treatment of medically necessary varicose veins a covered benefit however, it is subject to your cost share (deductible, coinsurance, copay and maximum out of pocket).
We are a Specialist office and many policies have a higher copay amount for Specialists.