A big part of what our staff does is help patients navigate our medicare and health insurance systems. At every visit, we check your medicare and insurance cards both visually and through our clearinghouse. This can help us prevent consultations that are not supported by third party payers. If a patient’s consultation is covered by a third-party payer that we are in network with, the rate for this visit is set by this company. Patients usually make a copay and then get billed for any part of the provider determined rate that the provider and the copay do not take care of.
After a visit, patients are often asked to get blood tests. This is one aspect of the financial experience of patients that we take no part in. We order and process these tests, a cost that is included in the payment for your visit. The patient’s process of getting radiologic imaging is similar although there are some tests that we file for prior authorizations for patients before the patients can get them done.
In the last 30 years, newly developed medications have made it possible to ease the burden of many of our patient’s ailments. Some of these medications can be quite costly. A rheumatology practice files for authorization of these medications and related services. Sometimes pharmaceutical companies offer services to support our patients and we aid patients in applying for this support.