Insurances will frequently force you to jump through hoops in order get reimbursed. As part of our service to our patients, we've put together a tutorial that may save you a major headache during this process.

Applying for reimbursement is straight forward.  You must submit two forms to the insurance company:

  1. The invoice from family Medicine, P.C. This form says “ Paid in full" in red letters and has Diagnostic ICD-9 codes and CPT billing codes on them which we either mailed or emailed to you, or which you collected at our office after a visit.
  2. An insurance claim form that can be downloaded from your insurance companies web site ( ) where you can get the Claim form for your specific insurance.  If you are unable to find a claim form for some reason, a more complicated but universally accepted claim form, " HICFA 1500 ,”  can be downloaded and submitted instead.

CLAIMS FORMS:

It takes several minutes to fill out the claim form.  Mail the invoice and filled out claim form to the designated address on the claim form or on your insurance card. 

Word of Caution (click here)

Keeping your information confidential might be important to you. Remember that every time you use your insurance company for payment, they systematically collect the diagnostic codes and any medicine you are obtaining ( if the insurance company is helping pay for them).   They also have the right to withhold payment until they audit your medical note.  This is a rare event.  At docto k r ® we never release the medical notes to insurance companies without your verbal and in some cases written consent. Our policy is that you paid us for the care and therefore the information for the visit belongs to you.

The insurance companies create a health information database like a “credit report” on any services they are helping you pay for.  This information can be used in the future to stratify your risks should you ever be looking to apply for health insurance in the future.  Claims adjusters have access to this file when they are trying to decide if you merit getting insurance.

 

 
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