Insurance and Fees
Insurance and Fees
When billing insurance companies and employer sponsored health plans, it is difficult to predict what insurance benefits will be paid. Also, if Concierge Medicine/ LA is not an in-network provider within your plan’s network, your responsibility may be the regular cash price of the Presidential Physical. Please check with your employer, insurance agent or other appropriate party and inquire if a wellness or screening physical examination is payable under your insurance coverage before coming to Concierge Medicine/ LA. It is very important that you know your insurance benefits. Many companies only provide “Usual, Customary, and Reasonable” (UCR) coverage. Since UCR allowances may differ greatly among insurance plans, the amount your insurance company reimburses may not cover full Concierge Medicine/ LA charges. Inquiries regarding insurance may be directed to our billing specialists at 310-826-2555.
If your insurance does not cover wellness (screening) physicals and you would still like to have a Presidential Physical at Concierge Medicine/ LA, you will be asked to pay a $1,000 deposit before/your appointment. When you schedule your appointment, you will be asked to provide a credit card number, or if you prefer, you may send a check and/or money order payable to Concierge Medicine/ LA along with your healthcare questionnaire. Concierge Medicine/ LA accepts Visa, MasterCard, American Express and Discover credit cards.
Some insurance companies required precertification certain procedures before they are willing to pay for them. Examples of services that may require precertification are: inpatient or invasive procedures, CT scans, MRI scans and colonoscopies. It is your responsibility to know the precertification requirements of your health insurance plan.
Hospital vs. Comprehensive Coverage
Under “insurance carrier definition,” Concierge Medicine/ LA is an outpatient diagnostic clinic, not a hospital. If your insurance policy is one that excludes coverage for outpatient services, your Concierge Medicine/ LA charges may be denied.
Deductible and Co-payment
Most insurance policies do not reimburse 100% of your charges for many healthcare services, including a Presidential Physical examination. Often, you are responsible for payment of the usual deductible and you are expected to pay a percentage of the charges. Please contact your insurance carrier for the specific benefit limitations of your policy.
Please note that Medicare does not pay for a Presidential Physical examination.
International patients are required to pay the estimated amount for each procedure listed on the
recommended package prior to their appointment.