Fees, Insurance and Financial Policies

All co-payments, deductibles, and fees for non-covered services are due at the time of your appointment. Failure to pay your co-pay at the time of service will result in a $20 billing administration fee in addition to the copaypayment, and/or we may ask you to reschedule your appointment.

There will be a missed-appointment charge if you fail to cancel your appointment within 24 hours prior to your appointment. The charge is $35. Weekends and holidays do not count in the 24 hours (ie calling Saturday or Sunday to cancel a Monday morning appointment results in a charge. Monday appointments need to be cancelled by Friday to avoid a charge). When you miss an appointment or cancel late, it denies another patient the opportunity to be seen, and the practice still bears the financial burden of rent, utilities, staffing, etc.. This policy helps us keep our fees as low as possible for our other patients.

There is an administrative fee for completing forms that take our providers away from providing care to other patients, such, as DMV, sport physicals, FMLA, leave of absence etc. Most forms require five to six working days to research your information and complete the form. You will be called when the form is complete and ready for pick up. If you have questions regarding a form or fee please ask the front desk personnel. The fees are also posted in the office.

Insurance and Health Plans
We will bill insurance carriers for you and collect their portion as a courtesy to you. You are ultimately responsible for all professional fees regardless of your insurance coverage status. Your insurance benefits are ultimately a matter between you, your insurance carrier and your employer. We are providers for: Brown & Toland, Aetna, Medicare, Blue Cross, Blue Shield, Cigna, Health Net, Pacific Care, CCN, and many others which you can find here.

Please note that our practice periodically must close to new patients in order for us to best serve our current patients.

We are currently closed to new Medicare patients, except for family members in the same household as current patients, or current patients converting to Medicare as they age.

We do not accept MediCal or Health Plan of San Mateo except as a secondary insurance for our Medicare patients. If you have a question about coverage under your insurance, please call our billing office at 415-493-3300 or ask at the reception window. You must provide us with your health plan card and/or all information necessary for us to bill your insurance carrier, or the fee for your visit will be due at the time of your appointment. You may need to obtain pre-authorization from your insurance carrier in order to avoid unnecessary cost to you for care that may not be included in your plan or our office, like X-ray, MRI, CT, lab tests, or specialist referrals. Please familiarize yourself with what your plan coverage is, or bring your benefits-booklet with you, or contact your personnel department or insurance carrier.

Prescription drug insurance-payment or specialist-referral authorization by your insurance plan may take up to two weeks for the insurance company to do all their paperwork back-and-forth with us, especially for newer or more expensive medicines or specialists. We focus on your health care, and provide you with what we believe is the best prescription or referral for you, at the time of your appointment. Employers change insurance plans, and insurance plans change pharmacy-benefits and specialist-membership all the time, to save money. We cannot possibly keep track of all the insurance company changes every year. Your best option might be to pay for the first prescription or specialist-visit yourself right away, so that you can have the benefit of the prescription or specialist until your insurance company finishes the paperwork, then reimburses you. If you are having a lot of problems with your insurance company not covering visits and prescriptions, or delaying your authorizations, you might want to select a different insurance company, or talk to your employer about it.

If you would like to learn more about insurance company and employer tactics to reduce pharmacy benefits and costs, go to Insurance Drug Benefits

If you would like to check out your insurance company's Report Card, go to NCQA

Auto Accidents and Personal Injuries (ie lawsuits)
If your problem is due to an auto accident or other "personal" injury involving another party please let us know at the time of making your appointment. Examples include injuries and conditions acquired at other businesses and homes, assault claims, accidents in the home, product defect accidents, and holiday accidents. Since your injuries may involve different insurance companies with whom we are not providers, payments for medical care are due at the time services are rendered. We do NOT handle auto-accident or Personal Injury Policy (“PIP”) insurance. We do not accept "liens" (i.e. "IOUs" from your attorney). We will give you a receipt which you can submit for reimbursement to the auto-insurance or PIP company handling it. We can provide you with copies of reports and paperwork for a minimal fee if you need them. Please call our billing office with any questions. We will suggest specialists or testing based on medical necessity in our opinion. It is your responsibility to find the X-ray, lab, specialist, chiropractor, acupuncturist or other specialist that will accept your insurance. Please call your insurance company, or the specialist to whom we refer you, with any questions about coverage. If these policies are not acceptable to you, you will need to find a different doctor or urgent care clinic for your auto accident or personal injury claim, though we can still see you for your other regular medical needs.

Workers Compensation
Our practice does not provide care for Workers Compensation cases (any injury, condition or complaint acquired-at or related-to your employment). Ask your employer for a referral to a Workers Compensation clinic, or look in the Yellow Pages for the nearest Workers Compensation clinic near you. If you wish supplemental private care, or a second opinion on the care you are receiving, we can see you on a cash basis with payment at time of service, as insurance coverage does not apply.

Call your insurance company or talk to your employer with any questions or concerns you may have about benefits.

PRIVACY:
You can find a copy of our HIPAA Privacy Policy by clicking here

©Bay Area Family Practice Inc. A Medical Group, 1850 Sullivan Ave, Suite 210, Daly City CA 94015 (next to Seton Medical Center)