Insurance/Fees
ABOUT MY FEES
My fee schedule is well researched and based on current market practices. It is important to me that you understand exactly what goes into making those decisions. Your fee is based on the time I spend with you during your visit, the complexity of your medical condition, and any treatment I provide. But proper attention to your care also requires that I-or members of my staff- spend additional time beyond which we spend with you in the office. This time is included in your initial fee and may be used to:
1. Create or maintain your permanent electronic medical record
2. Review, interpret, and document all lab test results and communicate those results to you.
3. Review current x-ray or scan reports, compare them with reports of previous scans, and when the studies are abnormal, consult with the radiologist or other specialist.
4. Consult via phone about your case with referring or consulting physicians and other health care providers.
5. Prepare referral forms to additional specialists as needed.
6. Conduct medical research relevant to your case.
7. Communicate with pharmacies about your prescriptions.
8. Draft letters of necessity and prior authorization forms to obtain medical services or prescriptions that you need.
9. Review hospital records and communicate with hospitalists regarding your care.
All these activities add to our cost of doing business. Still, my staff and I are committed to providing you with the best possible care at the lowest cost. I hope this explanation of my fees has been helpful.
INSURANCE
During my 15 years of medical practice I have watched insurance reimbursements remain stagnant or in many cases decrease. This process has forced contracted physicians to see more patients and spend less time with each individual, which has lead to dissatisfied patients and doctors. (www.independent.com/news/2009/aug/27/are-primary-care-doctors-going-way-dodo/?print) I chose to sever my contracts with most private insurance companies in 2005. This has allowed me to spend more focused time with each patient and provide them with the medical care they deserve.
If you have a PPO insurance plan you can still be seen by me. You will be reimbursed by your insurance plan at an out of network rate.
HMO patients seen here would receive no reimbursement from their insurance plan.
I remain contracted as a preferred provider for Santa Barbara Cottage Hospital Insurance plan and am contracted with Medicare as a non participating provider. This allows me to collect the Medicare allowed amount fee at the time of service and patients receive reimbursement directly from Medicare.
We do submit your primary insurance claims electronically as a courtesy to you and patients can generally expect to receive insurance reimbursements within 2-3 weeks.
