Although our practice providers are considered out-of-network with Anthem Insurance, we want you to be aware that the difference in cost to you may not be as significant as you would think.
While we ask that you pay out of pocket for your office visits (typically $75-$100), we offer a 10 percent discount for doing so. After your visit, our office will submit the claim to Anthem on your behalf; then Anthem sends you a check for any out-of-network benefit to which you are entitled. And if you have a Flexible Spending Account (which allows you to save pre-tax dollars for annual medical expenses), you can be reimbursed for any remaining expenses through your account.
Note that all hospital stays, tests and lab costs (such as blood work, mammograms, etc.) will be covered as an in-network service; just the office visit would be an out-of-network expense.
For example, for most patients, the charges/reimbursement for a physical and two sick visits per year (3 total visits) would look like this:
*$300 out of pocket (total for three visits) paid at time of service
*$125 – $175 reimbursement mailed back to you from Anthem as an out-of-network benefit
*Total annual expense to you – $125 – $175
Compare this to in-network charges of 3 visits at $35 each (average co-pay for an in-network provider visit), resulting in total annual expenses of $105. So, by remaining with our practice, the annual difference in cost to you is approximately $20 – $70 additional.
We value our relationship with you and hope you’ll continue choosing our practice as your “medical home.” We are committed to high-quality, evidence-based medicine and want to ensure the continuity of your care throughout your life.