Information for Insurance Reimbursement

When you call your insurer, you should ask the following questions:

If I use an Out of Network Provider, to what degree does the policy cover:

  1. Preventative visits (codes 99381-99384 for new pt, codes 99391-99395 for established pt)
  2. Sick visits (codes 99201-99205 for new pt, codes 99211-99215 for established pt)
  3. In-hospital care for a new baby (codes 99460-99465)
  4. In-hospital care for a child (codes 99222-99239)
  5. House call visits (codes 99341-99345 for new pt, codes 99347-99350 for established pt)
  6. Vaccinations and lab fees:

vaccinationchart
 

If you choose to use our practice, you may find it advantageous to alter your current plan.

A few suggestions are listed below.  Please keep in mind that each family’s situation is unique and you should be guided by your personal financial, tax, and insurance advisors.  These suggestions are not intended as specific advice and may become outdated without notice.

  1. Increase your health insurance deductible.  By increasing your deductible, your monthly premiums may be greatly reduced, resulting in significant annual savings.
  2. Establish a Health Care Reimbursement Account (HCRA).  If you are an employee, you may qualify for a Health Care Reimbursement Account as part of your benefits.  This account allows you to set aside a pre-determined annual, pre-tax amount to be spent on health care expenses.  Please note that if you choose this option you must carefully track your expenses, as you will forfeit any balance remaining at the end of the year.
  3. Establish a Health Savings Account (HSA).  If you are self-employed and have a high-deductible policy, you may qualify for a Health Savings Account, where you can deposit a pre-determined amount to be spent on health care expenses.  Your contributions accrue interest and any unused balance rolls over each year.