Insurance Information  

 

We accept all insurances.  We are currently contracted with Medicare, Blue Cross, Blue Shield, and GEHA.

 

When you come to our office, the doctor will keep track of what services he gave you.  We will, then, bill your insurance agency for those  services.  We have "our charge" (charge), and your insurance agency has "what they will pay" (allowed amount).  These allowed amounts are acquired from guidelines - of what Medicare would pay for the same services.  Doctors, usually, bill higher "charge amounts" to the insurance agencies, than what the insurance agencies will pay (allowed amounts).  These charges are divided into, and may show up on your EOB as "allowed amount," "co-insurance," "deductible," "co-pay," and / or "amount paid."

 

Beginning March 1, 2008, we will be changing our billing methods.  To make it better, and more affordable for you, we will be reducing our prices, and you will need to pay for your services - up front (patients with Medicare insurance will not have to do this).  We will then bill your insurance ,and the payment we receive from your insurance, will be credited back to your account.  This money can be used for future appointments, or you may choose to have the money refunded back to you.

 

You can always appeal your insurance's decision on any claim.  Usually, this will work best, if you call your insurance - with an aggressive tone of voice.  Using phrases, like, "According to Medicare's web site, your pay rate should be '$  .  ;" or "I think your payment of $  .   is terrible for my office visit."  This makes your insurance company feel bad, and may have a positive affect on getting your claim reprocessed for a higher payment.  The reason for this, is you pay your insurance a monthly premium.  If they feel you are upset about one of their decisions of a payment, you may take your insurance business elsewhere ... and they will loose your monthly premium.

 

Jim has been successful in helping some of Dr Wilde's patients (with dealing on how to approach insurance agencies) to request a reconsideration of payment.  If you would like to discuss any insurance matter, feel free to contact him at (805) 504-4678.