Financial / Insurance Information
FINANCIAL INFORMATION ABOUT HEALTH INSURANCE AND CASH PRICING
Pacific Coast Urology Medical Center accepts Medicare, most PPO health insurance plans and a few select HMO health plans through our participation with the following medical groups:
- Arta HMO – through Arta Medical Group (a division of HealthCare Partners)
- Prime Healthcare
- ADOC/Regal Medical Group (ADOC must be associated with the Regal group. Please note that we are unable to see Lakewood or Long Beach ADOC/Regal Groups)
We participate in the Medicare program and will submit your claim directly to Medicare. If you have a Medicare Advantage plan, we will need to verify if we are contracted with your plan before booking your appointment. If we are not contracted with you plan, we want you to know that in advance of obtaining services as you would be financial responsible for all expenses that are not covered. You are responsible for your deductible and co-insurance payments at the time you receive a medical service.
In an effort to simplify the handling of your insurance claim, we will provide you with a monthly statement and information that you may need for insurance purposes. We acknowledge your need for a clear understanding of the financial arrangements for your medical care. Therefore, a discussion of fees for planned diagnostic or surgical procedures is both welcomed and encouraged.
IMPORTANT INFORMATION ON THE AFFORDABLE CARE ACT (OBAMACARE)
In response to inquiries about the Affordable Care Act (Obamacare), Pacific Coast Urology Medical Center advises our patients that we contracted with only one Affordable Care Act (Covered California) policy. Be prepared to share your insurance information when you call for a consultation so we can verify if we are contracted with you plan before your visit.
Please call our office for more specific information. We’ll gladly check your insurance coverage with our financial counselor. We offer affordable cash pricing for you if you don’t have an insurance plan with which we participate of if you do not have health insurance (see below).
YOUR FINANCIAL RESPONSIBILITY AND REQUIRED FORMS
Whenever you visit our office, please be sure to bring your health insurance card and identification information (such as a driver’s license). Please note that your insurance may require prior authorization before being seen at Pacific Coast Urology Medical Center. We’ll do our best to find out about that and assist you but, in the end, it’s your responsibility to understand the requirement of your health insurance plan. If authorization is required by your health insurance, please ask your primary care doctor or insurance company to fax your authorization to 562.594.9010 to ensure you aren’t billed for services covered by your insurance. We may need to call you for insurance or authorization information before your appointment.
Your insurance may require an office co-payment or you may have a deductible payment. If so, you must pay it in full at the time of your visit. Any fees not covered by an insurance plan must be paid when you arrive at our office.
Please remember that, while we are more than happy to assist you with determining insurance benefits for covered services, copayments or deductible payments, the information we provide is usually only an estimate from your insurance company. If your insurer determines that you are responsible for a higher payment after a service is rendered, you are required to pay that amount in full.
NEW PATIENT REGISTRATION FORMS
We know that these can be bothersome and time consuming. We’ve done our best to limit the information we require to make your initial experience with us as easy as possible. You can download our easy to understand, new patient registration forms so you can fill them out at home. Just email or fax them to us or bring them with you when you come in for your initial appointment.
CHANGES TO YOUR INSURANCE
If your insurance plan changes you must tell us before we provide a service to you. This includes everything from a basic office visit to a surgical procedure. All insurance plans vary in their requirements. If you do not tell us if your insurance has changed we may not be able to bill your insurer and you will personally be responsible for all charges.
FINANCIAL RESPONSIBILITY POLICY
To read about your financial responsibility please click here to download information about this.
CASH PACKAGES FOR SELECT SERVICES
We want to make our remarkable minimally invasive services and excellent customer service available to as many patients as possible. For that reason, you will find our “cash” prices significantly lower than many other urology practices.
So, we offer very affordable packages for you if you do not have insurance or if we do not participate with your insurance plan. As an example, we see many patients on a “cash” basis every week for services such as our No Needle/No Scalpel vasectomy and circumcisions for men and bladder control for women.
All payment are required when a service is provided.
For your convenience, we accept cash, debit cards, all major credit cards and Apple Pay. We do not offer financing but can refer you to companies that may be able to do that for you. If you have any questions about any financial matters, please call us and ask to speak with our office manager or our financial counselor at 888-735-4336.