Each time a patient comes into the office for a
visit, we have her review and initial our financial policy. To view the most
recent version of our financial policy, click here.
Patients
on GEHA
Dr. Thiel is a provider for GEHA insurance.
If GEHA
is your primary insurance, our office will submit claims to your
insurance company. Each patient is responsible for paying the co-pay at the time
of service. It is your responsibility as a patient to know the amount of your
co-payment. If a balance remains on your account after GEHA processes your
claim, you will be expected to pay the balance immediately.
Patients Covered by All Other Insurance
Companies
Our office will not submit to other insurances. Instead, we
provide a fee slip after each appointment, which contains all the necessary
information to submit claims to insurance companies. Patients are required to
pay for their visits in full when services are rendered. For Blue Cross/Blue
Shield - Federal patients, we provide copies of the required claim form. As
always, patients with financial hardships can notify the front desk supervisor
prior to the visit to arrange a payment plan.
Regardless of your
insurance policy, our office will keep you insurance information on file, in
case we need to order additional testing on your pap smears.
Dr. Thiel
has also written a letter describing her thoughts on health insurance today,
which you can read here.
Patients
on Medicare
Dr. Thiel has OPTED-OUT of Medicare. As a result, neither
the office or the patient may submit to Medicare. At the time of visit, a
Medicare patient receives a copy of the Medicare Opt-Out Contract, which can be
submitted to a secondary insurance with the superbill for the visit. This
informs the secondary insurance of Dr. Thiel's opt-out status.
We provide
Medicare patients a discount for our services. The labs we use for bloodwork and
cultures file with Medicare -Medicare Patients will not be charged up front for
these tests. The lab does reserve the right to balance bill Medicare patients
for tests not fully covered by Medicare.
How to submit to your
insurance company for reimbursement
At the time of your visit you
will receive two copies of your statement for the visit. One copy is for you to
keep for your records and the other can be used to submit to your insurance
company. Send the copy of your fee slip with the information provided on your
insurance card (Group # and ID#) to the address on the back of your insurance
card. Most plans require that you submit your bill within six months of your
visit, however insurance plans differ widely and you should contact your
insurance company for their specifications. Payment from your insurance company
should be sent to you directly, however if our office does receive a payment
from your insurance company we will refund you via check within one month of our
receipt of the check. Please keep in mind that you often receive your insurance
invoice before our office receives the duplicate copy.
Tips
for Submitting to Insurance
Contact you insurance company to learn the details of your policy and
coverage prior to you appointment.
Submit your superbill soon after the appointment; preferably send it out on
a Friday afternoon.
If your claim is denied, review why, make any necessary corrections, and
resubmit.
If you have any complaints regarding the handling of your claim, contact the
VA Insurance
Commissioner.
If you have any further questions regarding our financial and insurance
policies, feel free to contact our office and speak with the receptionist or
office manager.
Annual Exam (including breast and pelvic exams, Pap
smear, urinalysis, prescriptions for one year, stool test (age 50+), and orders
(ex. Mammogram order ages 40+)
Ages: Estimated
Cost: 12-17 . . . . . $261 18-39 . . . . . $266 40-64 . . . . .
$299 65+ . . . . . . $299 ($237 for Medicare Patients over age 65, our lab
currently bills Medicare for your pap smear)
Lab work will
not be done unless medically indicated to Dr. Thiel. Some lab work, such as
Hormone Replacement Therapy (HRT) Levels must be done by our office as we have a
special lab run these tests. STD screens are performed if the patient has had
any new sexual partners since their last visit or if otherwise indicated.
2. How much will my insurance reimburse me?
Your
insurance is a contract between you, your employer, and your insurance company.
We are not a party to that contract in any way. Everyone's insurance plan is
different. There is no way for our office to know exactly what each patient's
insurance coverage provides. It is the patient's responsibility to know the
details of their own insurance coverage. To find out what your plan covers speak
with your employer or contact your insurance company directly.
3.
Do I have to pay a fee to be part of the
practice?
No.
4. What if my insurance doesn't pay,
stating that the fee codes are wrong?
Put your request for corrected
codes in writing and mail us a copy of the insurance letter stating the codes
were wrong. We will review the original fee slip, make necessary changes, and
send the corrected forms to you to resubmit to your insurance company.
Please understand that most of the time the codes were correct to begin
with and this is a stall tactic. It is insurance fraud to change codes just to
receive payment. Your visit is coded for the reason you come in. If you do not
have coverage for routine/annual exams but this is the reason for your visit,
you may not receive reimbursement from your insurance company. Contact your plan
administrator for details of your insurance contract. Reimbursement
rates/coverage policies are at the discretion of your insurance company and not
contingent on our office.
5. What if I lose my fee
slip?
Since you receive 2 copies of your fee slip at your visit,
there is a $15 replacement fee for lost forms. After the fee is paid (we can
take cards over the phone) before duplicates will be mailed to you or available
for pick up.
6.Will your office call my insurance company on my
behalf?
Since we are not a party in the agreement between you and
your insurance company, we are unable to contact your insurance
company.
7. Can Dr. Thiel provide routine bloodwork and
care?
Certain lab work must be done at our office, such as Hormone
Replacement Therapy (HRT) levels, since we use a special lab for the most
accurate results.
Our office will gladly draw any other lab work at your
visit. You will receive a copy of the lab work with Dr. Thiel's comments in the
mail after she has reviewed them. Please keep all results in your personal
records so that you may take copies of them to other doctors as needed.
If you wish to have blood work drawn at a lab that accepts your
insurance (please contact your insurance company for this information), Dr.
Thiel will provide you with a prescription for the blood work she needs. If
blood work is drawn at a lab you must make a follow-up appointment to discuss
the results with Dr. Thiel. Results will not be discussed over the phone.
8.What if I want to switch doctors?
If you are leaving
the practice and would like your records transferred to another doctor, we must
receive a written request authorizing the release of your records. You can use
our Records Release Consent Form here.
In addition, we charge $27.50 (by check or credit card) for the copying service,
and you must pay any outstanding balance you may have in order to close your
account. If you need more than one copy please indicate this on your written
request and include the necessary payment for each copy of your records.
When sending your request please include your full name, address, date
of birth, name and address of the doctor you are transferring to (this is where
your records will be mailed), or indicate that you will pick up the records,
signature, date, and form of payment. Please make payments out to Dr. Melissa
Thiel and allow 3 weeks for processing.
