What you can expect to pay
My practice philosophy and my payment polices (below) allow me to keep my prices lower than other gynecologists in my area. I accept Medicare's reimbursements in lieu of these prices. All other patients are expected to pay in full at time of service. I provide my patients with documentation for filing insurance claims.
Prices are subject to change without notice.
Payment and insurance
I strive to offer the very best medical care at a fair and reasonable price. Because one costly aspect of medical practice is dealing with insurance payors, I chose in 2001 to sever my relationships with all private healthcare firms, HMOs and PPOs, and offer my services only directly to my patients. All patients are responsible for the costs of their treatments.
All non-Medicare patients are expected to pay at time of service. I accept checks, Visa and MasterCard. I will provide you with documentation sufficient to file a claim with your insurance carrier. Your insurance carrier will then reimburse you directly. <see full policy>
Medicare-as-PrimaryMedicare-as-primary is the only insurance system I work with, and I will submit the initial claim to them. Medicare patients are responsible for co-payments, deductibles, and for filing any secondary insurance claims, if needed. If Medicare has a secondary payor on file, then they will forward the claim to that insurer. Ultimately, after all insurance has remitted, any outstanding allowed fees are the responsibility of the patient. <see full policy>
Medicare AdvantageI do not accept Medicare Advantage insurance for payment. Please <see full policy>.
Billing for missed appointments
My office will charge $20 for missed appointments. The office staff makes sincere efforts to contact each patient the business day prior to her appointment as a reminder and confirmation. If you are unable to make an appointment, please call no later than the prior business day so that the office may contact others who are waiting to be seen. If you fail to contact the office and do not appear for your appointment time, my office will send you a bill for $20. This bill is your responsibility and will not be covered by insurance. We would much rather not charge this fee, so please call us as soon as you know that you cannot make an appointment date and time.
Notification of balance due and re-billing fees on overdue accounts
As appropriate to your standing as Medicare or fee-for-service, I will send you a notice of any outstanding balance for services. You will have 30 days to remit payment. If I do not receive payment within those 30 days, I will send you a second bill that will add a $10 fee for re-billing.
Billings for telephone consultations
I welcome short telephone calls asking for clarification of instructions or to handle urgent health matters. If I believe that your telephone call should become an office visit, I will suggest that you make an appointment. If that is not possible for you, then I will do what I am able to help you over the phone and then send you a bill for the telephone consultation. The charge will be between $25 and $100 depending upon the duration of the call.
Billing for "Prior Authorizations" and "Formulary Exceptions" - consider GoodRX.com
In recent years, I have received numerous requests for "Prior Authorizations" and "Formulary Exceptions" for ordinary medications, denied by patients' insurance companies. Each one of these takes 20-30 minutes of my time, whether I try to accomplish them by telephone or online. I need to provide the patient's name, address, birthdate, phone, and insurance ID in addition to my name, address, phone, fax, NPI, DEA, in addition to a diagnosis code and why the patient requires that particular medication. Sometimes considerable expertise, literature review and review of your medical records are required also.
I recently read in the New York Times about an organization "GoodRx" that provides medications at lower cost. I had thought this organization was for people who had no insurance, but in fact GoodRX is often able to provide a better price than your insurance will. I recently had occasion to apply to my insurance for a medication denied for myself, only to find out that having spent the time to do this only reduced the cost of the medication by about 15%--BUT by asking the pharmacist to check GoodRx.com, I got over a 50% reduction in my cost.
I therefore urge you to check, or have your pharmacist check GoodRx.com before asking me to complete a PA or Formulary Exception for medications I have prescribed for you. I will henceforth charge a $25 fee for completing these documents, payable by credit card before I fill them out.
Since I went into practice in 1980, prescription prices have gone through the roof--even the price of generics--at increases well beyond cost-of-living. I would urge you to contact your government representatives to JUST DO something about this outrageous cost to the American people, which we all subsidize through Medicare, Medicaid and Armed Forces and VA benefits.
Revised December 2017