Transparent Primary Care Fees in San Antonio

(Please read this very carefully)

Innovative Primary Care is committed to reducing waste and inefficiency and making our billing process as simple and easy as possible. Starting January 1, 2023, we now are requiring that you provide a credit card on file (CCOF) with our office. We run our payments through our HIPAA-compliant, secure practice management software Practice Fusion. When you come in, we will scan your card with a card reader. Your payment information is stored on Practice Fusion’s secure servers for future transactions. Office personnel will not have access to your card. For your protection, only the last 4 digits of your card will show in our system.

Credit Card on File will be used to pay account balances after insurance adjudication. Co-pays will still be collected at each visit (if applicable). We will submit all patient claims to insurance as usual. Once your insurance has processed your claims, they will send an Explanation of Benefits (EOB) to both you and our office showing what your total patient responsibility is. You typically receive the EOB before we do, so if you disagree with the patient responsibility amount owed, it is your responsibility to contact your insurance carrier immediately.

Notes:

During the time you leave a credit card on file, if it expires or otherwise becomes uncollectable, we will expect you to promptly provide a new means of payment.

Credits on your account after your insurance claim has been adjusted will be returned to the credit card on file. Ultimately, you are responsible for knowing what services are covered, how often, and how much of the cost is your responsibility. You will be responsible for any portion of services that your insurance does not cover.

To avoid any issues of discrimination or favoritism; all patients will be required to have a credit card on file regardless of insurance or visit type.

FAQs:

When I booked my appointment, the receptionist told me I had to keep a credit card on file with the office. I’ve never heard of that before.

This is not surprising that this is new to you, as it is not yet the norm in this area. Credit Card On File (CCOF) is the new standard in the healthcare industry nationwide, and soon all of the high-quality medical practices will adopt it. We are not the first to do this. Insurance reimbursements are declining and the expectation is that health care providers find ways to become more efficient. With the Affordable Care Act and the Health Exchanges, we are seeing a massive increase in patient deductibles. These factors are driving many medical offices and clinics to either squeeze more patients into shorter periods or stop accepting insurance. We have decided to focus on becoming more efficient instead.

How does CCOF work? I’m nervous about giving up my sensitive financial information.

Your card information is securely protected by the credit card processing component of our HIPAA-compliant practice management system. This system stores the card information for future transactions using the same sort of technology that credit card companies use. We cannot access the entire card number – we only can see the last 4 digits. There is no way to export the card information out of our system. We can only use it to process a payment in our practice management system, which creates an indelible record (one that cannot be deleted).

How does the credit card on file system work to drive down administrative costs?

Our staff will now spend less time entering credit card information for each transaction. We also don’t have to send out as many statements, which saves trees, money, and time. Once your CCOF is in our system, check-in and check-out time is much shorter for you as well.

I always pay my bills on time. Why do I have to do this?

The entire billing process is wasteful but the few patients that we have to bill multiple times or even send to a collections agency do cost us a lot of time and expense. Reducing unnecessary costs is essential for us to continue to accept insurance and Medicare. This new process dramatically cuts down on the administrative costs associated with billing. We have already dropped Medicaid due to the billing inefficiencies and administrative burdens.

Nothing is changing about how much you pay. When you come into our office and receive a service, you do so with the understanding that you are ultimately responsible for the cost of your care. We bill your insurance company for you, and we have contracts with most insurance companies that help to get you the best possible coverage for your care. CCOF will only cover your responsibility after your insurance pays its contracted share.

How the CCOF process benefits patients.

First and foremost, it is far more convenient for you – you don’t have to call the office, buy a stamp, or worry about getting around to paying the bill. It takes the hassle out of the process, especially for patients who have HSA cards to pay for their medical care. If you get your statement and want to use a different card, pay by check, or discuss a payment plan, you may still do so as long as you do so promptly.

What if there is a problem with my bill and I don’t notice it until after the payment process?

We hope that this doesn’t happen. Although we love technology in this office, we routinely review the accuracy of claims processed by insurance and will contact you if WE find a problem. But, if you find a problem, call us and we’ll investigate it. If we owe you money, we will refund it promptly to the same card, instantaneously.

The only patients not required to provide a “Card on File” are listed. All other patients must provide a “Card on File”.

Patients experiencing a medical emergency

Medicare or dual coverage patients

Self-pay-Fee For Service or DOT patients when the visit is paid in full at the time of service,

Occupational Medicine and Workers’ Compensation patients

Direct Primary Care (DPC) members of our sister company Sana Vida Wellness Center.

What happens if I do not have a credit card?

We also accept:

HSA

HRA

FSA

Debit Card

CareCredit

What is a deductible and how does it affect me?

An annual deductible is the dollar amount you must pay out of pocket during the year for medical expenses before your insurance coverage begins. For example, if your policy has a $500 deductible, you must pay the first $500 of medical expenses before your insurance company begins to pay for any services.

How will I know if my deductible has been met?

You may find out when your deductible is met by calling your insurance company at any time. Some insurance companies also have this information available online.

For those who refuse to follow our new policy, we will offer them a cash office visit fee to be paid before seeing their clinician each time. Today’s cash price for care is $159 but is subject to change with advanced notice. We are a transparent company. A complete list of in-network carriers, a comprehensive list of our cash fees, and a copy of our CCOF policy can be found on our website at https://innovativeuc.com/insurance.

Thank you,

Dr. P. John Schanen, APRN, FNP-C, ENP-C

President and CEO

Insurance companies have complete control over payments and dictate the time allotted for your visit. To keep our practice running smoothly, we ask that you adhere to the following guidelines concerning your appointments and appointment times.

Most appointments are 15 minutes long. So that other patients may keep their scheduled appointment time, we would appreciate you keeping your issues to one major or one minor problem during your appointment. This will allow our clinicians to devote their attention to the issue that concerns them the most while minimizing the wait time for other patients. We will do our best to accommodate your needs and help with any issues that run past the 15 minutes.

If all of your issues or questions aren’t resolved during the 15-minute appointment, please make a follow-up appointment to address those issues.

Physical Examinations require 20-30 minutes and focus on identifying any major issues. If you have major medical issues that need to be addressed, we ask that you make a separate appointment.

We understand that situations arise in which you must cancel your appointment. It is therefore requested that if you must cancel your appointment you provide more than 24 hours notice. This will enable another person who is waiting for an appointment to be scheduled in that appointment slot. With cancellations made less than 24 hours notice, we are unable to offer that slot to other people needing care.

As a courtesy, and to help patients remember their scheduled appointments, Innovative Primary Care Clinics sends text message and email reminders 9 days, 7 days, 4 days, and 24 hours in advance of the appointment time.

Office appointments which are cancelled with less than 24 hours notification may be subject to a $75.00 cancellation fee.

Patients who do not show up for their appointment without a call to cancel an office appointment are considered a NO SHOW. Patients who No-Call, No-Show three (3) or more times in a 12 month period, may be dismissed from the practice, thus they will be denied any future appointments.

The Cancellation, No-Call, No-Show fees are the sole responsibility of the patient and must be paid in full before the patient’s next appointment.

We understand that special, unavoidable circumstances may cause you to cancel within 24 hours. Fees in this instance may be waived but only with management approval.

Innovative Primary Care Clinics believes that a good clinician/patient relationship is based upon understanding and good communication. Questions about cancellation, no call, no show fees should be directed to the clinic manager at (210) 455-6253.

We accept most private insurance. Please be prepared to show your insurance card at every visit. Keeping your records up to date helps us expedite referrals and authorizations necessary for your care and ensures we have the information needed to bill your insurance company accurately and timely.

Payment is due at the time services are rendered. Your payment may consist of an insurance deductible, a co-payment, co-insurance, or full payment for uninsured patients or those services not covered by an insurance plan.

As a courtesy, we will bill your insurance company for you. If there is a difference between what they pay and the actual bill, you will be expected to pay the balance to our office.

Medicare

Medical care must be deemed medically necessary to be covered by Medicare.

You need to understand that Medicare does not cover everything and it does not pay the total cost for most services or supplies that are covered. You should talk to your doctor to be sure you are getting the services and supplies that best meet your healthcare needs.

The amount of your coverage is also dependent on whether you have coverage under Medicare Part A, Medicare Part B, or both.

Medicare Part A helps cover your inpatient care in hospitals, including critical access hospitals and skilled nursing facilities (not unskilled or long-term care). It also covers hospice care and some home health care. You must meet certain conditions to get these benefits.

Medicare Part B helps cover physician services, outpatient hospital care, and some other medical services that Medicare Part A doesn’t cover, such as some of the services of physical and occupational therapists and some home health care. Medicare Part B helps pay for these covered services and supplies when they are medically necessary. It also covers your annual preventive services.

If you belong to a Medicare+Choice plan, it must cover at least the same benefits covered under Medicare Part A and Part B. However, your costs may be different and you may have extra benefits, such as coverage for prescription drugs or extra days in the hospital. You should contact your Medicare+Choice plan administrator for specific coverage information for the plan in which you are enrolled.

Medicaid

At this time, we do not accept Medicaid for primary care services.