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INSURANCE INFORMATION


How Do We Handle Billing and Insurance?

Our physicians participate with the majority of managed care plans, including HMOs, Medicare HMOs, PPOs, and Point of Service plans. In addition, our physicians are participating Medicare providers. When you register at Palm Beach Diabetes and Endocrine Specialists, we enter your insurance information into our computer system and file claims according to your insurance plan’s policy. If you have no insurance, payment is expected at the time of the appointment. HMO patients are responsible for obtaining their own referrals and presenting such authorization to us prior to the visit or when you register at your appointment. We accept cash, personal checks, Mastercard, and Visa.


Insurance and Fees

Our professional fees are well within the range of usual and customary charges for our specialty and region. We request and expect full payment at the time of service. All patients, including those covered under insurance plans in which we participate, are required to pay their co-payments, and deductibles at the time of service.

We currently accept the following Insurance Plans:

ACCORDIA
AFFORDABLE
AETNA INCLUDING (AETNA MEDICARE OPEN)
AMERICAN HEALTHPLAN
B/C B/S (PPO, HMO, POS)
BLUE OPTIONS / NETWORK BLUE
BENESIGHT
BEECHSTREET
CBCA
CAPPCARE
CCN
CHAMPUS
CHAMPVA
CIGNA (ALL LINES OF BUSINESS)
DIMENSION
ECN
INTERPLAN
FIRST HEALTH
GOLDEN RULE
VISTA, HIP, SUMMIT (ALL LINES OF BUSINESS EXCEPT MEDICAID VISTA HMO)
HEALTH ADVANTAGE NETWORK ( DISCOUNT CARD)
HEALTH OPTIONS
HUMANA ALL LINES OF BUSINESS EXCEPT (HUMANA MEDICARE PPO)
HEALTH PLANS OF AMERICA
MEDICARE
MUTUAL OF OMAHA
MULTI-PLAN (NOW INCLUDES PHCS)
NPPN (DISCOUNT CARD)
PREFFERED HEALTHCARE NETWORK AKA PHN (PRINCIPLE PLAINES)
SOUTHCARE
TRICARE
UNICARE
UNITED HEALTHCARE INCLUDING (NEIGHBORHOOD HEALTH PLAN)
UNIVERSAL HEALTHCARE PPO (EXCLUDING UNIVERSAL HEALTHCARE HMO)


WE DO NOT PARTICIPATE IN THE FOLLOWING:

TRADITIONAL MEDICAID
UNITED HEALTHCARE MEDICAID
AVMED
UNIVERSAL HEALTHCARE HMO
GHI PRIMARY
OR ANY OTHER PLANS NOT ON THIS LIST


We will bill your charges directly to any plan in which we participate. You will be expected to pay us directly, for any co-payment, deductible or charges, which your plan determines to be the patient's responsibility. If you are not sure whether our physicians participate with your insurance plan, please ask one of our staff members. They will be happy to answer your questions.

You are ultimately responsible for charges incurred through our office
should your insurance company fail to pay or delay payment.