Billing

OUR SERVICES

Billing and General Information

 Health Maintenance Organization (HMO) vs Preferred Provider Organization (PPO)

HMOs:

May require a referral from your primary care physician (PCP), who will determine what treatment you need. If you opt to see a doctor outside of an HMO network, there is no coverage, meaning you will have to pay the entire cost of medical services.

PPOs:

You can see the doctor or specialist you’d like without having to see a PCP first. You can see a doctor or go to a hospital outside the network and you may be covered. However, your benefits will be better if you stay in the PPO network.


IN NETWORK/OUT OF NETWORK INSURANCE:

Regardless if your insurance is in-network or out-of-network, we will be glad to file it for you. We recommend calling your insurance company before your visit to verify your benefits to know if you are paying in network or out of network prices.

We are a Medicare provider and a "Non-Network Certified Provider for Tricare East/Select". (Prime needs referral)


REFERRAL REQUIRED INSURANCE

If your insurance has a PCP listed on your card, you will most likely you will need a referral from your PCP that has to be approved by your insurance. We recommend you call your insurance company to verify if you need a referral. We must have the referral number from your insurance at least 2 days prior to your visit or you will have to pay cash for the visit. (Examples: Cigna HealthSprings, UHC Community Plan)


PROGRAMS NOT ACCEPTED

(Medicaid, Healthsharing, Discount Programs)

If you have Medicaid or health sharing plan (IE-Liberty Health Share; Medi-share, etc) you will have to pay cash for your visit. Per request, we will print out a claim form on your behalf if you wish to file the claim yourself.  We are not a MEDICAID provider and can not file claims on your behalf.


BILLING

We will attempt to file all insurances except Medicaid. It is the patient's responsibility to check with their insurance PRIOR to their visit to confirm coverage, copay, and deductible amounts. Depending on your insurance coverage, your lab work may be billed via the third party lab company that processes your lab work. You will need to contact these companies directly if you have any questions regarding their bills.


 

All the services you need, all in one place.

Patient Portal Healow Practice Code: FABIAA

EWOG Patient Portal

3 STRIKE POLICY - We will no longer provide your medical care after 3 strikes:

  1. Appointment not cancelled 24 hours prior
  2. Greater than 10 minutes late for appointment
  3. Failure to show

PRESCRIPTION POLICY
We encourage our patients to be pro-active in their health care and seek needed refills on a timely basis. Because prescription refills require authorization by your Provider, we ask that you allow 48 hours to obtain refills.

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