Insurance Insurance and The Payment Process
Doctors Making Housecalls accepts Medicare patients, self-pay patients, and patients with insurance that allows them to see the doctor of their choice. Our practice works on a fee-for-service basis, which means we ask patients to pay at the time of service -- except for Medicare patients, as explained below.
To make the payment process simple and convenient for all concerned, we accept credit cards. Then we electronically file the forms you will need to receive reimbursement from your insurance carrier. Electronic filing ensures the fastest possible claims processing. Under certain circumstances we will accept payment by personal check; however, the check must be in our office prior to your appointment.
Doctors Making Housecalls charges a service fee of $85.00 for scheduling the physician who provides your care, and to account for the physician's travel time, which is not reimbursed by insurance. We will charge this amount to your credit card at the time we schedule a physician, after you have accepted the appointment.
The fee for the professional services of the physician will vary according to the amount of time the physician spends with you, and the complexity of your medical problem. Our professional fees are comparable to those of office-based physicians.
If the physician orders laboratory tests or radiologic procedures, whoever performs those services will bill you separately. Your insurance carrier should reimburse those fees just as they would if the orders came from a typical office visit.
Medicare
We accept assignment, which means we bill Medicare directly, and all secondary (Medigap) insurance plans. You only pay what's not covered by your insurance.
Medicare reimburses 80% of our physician's professional fee, once you've met your annual deductible. Many supplemental insurance plans pay the remaining 20% of the physician's fee, and some even pay your annual deductible. Some supplemental plans pay our practice directly, but some send payment directly to you.
We ask Medicare patients without supplemental insurance to pay their 20% co-pay at the time of service. Similarly, if your supplemental carrier sends payment to you, we ask that you pay us at the time of service since you will be reimbursed directly by your supplemental carrier.
We charge a service fee of $85.00 for visits to a patient's home or place of business. We do not charge that fee when we see patients in one of the senior or assisted living communities we visit on a regularly scheduled basis. And of course we do not charge that fee to patients who see us in one of our offices.
Medicare does not reimburse our service fee because it is an administrative charge for scheduling the physician, not a fee for the physician's professional services; therefore it is not considered "medically necessary" by Medicare.
Other Insurance -- BCBS, Humana, Cigna, State Employees, etc.
We file claims electronically in your behalf, at no charge. Because there are many insurance carriers and each carrier has many different plans, it is impossible to know how a given insurance plan will reimburse our fees.
You should not expect reimbursement for our $85.00 service fee/trip charge, because it is not a fee for the physician's professional services, it is an administrative charge for scheduling the physician and to pay for travel time. We hope that will change in the future, as insurers come to value housecalls as much as their clients.
