Insurance FAQs

Nov 01, 2019

1) Do you accept insurance?

Yes! We accept many types of insurance, including most major providers. Please read on! ☺️

2) What kind of insurance do you accept?

At PFI, we accept insurance by most major companies. To confirm whether we accept your specific insurance plan, please call the office. But the following are insurances that we typically accept:
a. Aetna
b. Blue Cross Blue Shield
c. United HealthCare
d. Medicare
e. Cigna (except through Baycare)
f. Optum
g. Liberty Healthshare
h. Tricare
i. Humana

This list is far from the full breakdown of the various carrier-specific plans that we accept, but we hope this will give you a better idea of what you can expect when you call for your appointment.

3) How much will my copay be?

Co-payments for each visit can vary from carrier to carrier and plan to plan. And the last thing you’ll want is an inaccurate estimation based on someone else’s plan. So the best way to find out exactly how much you can expect to pay as a co-payment is to call your insurance company.

Often, your insurance card will feature a patient care number on the back. You can call this number and ask what your specialist co-pay will be. If you aren’t able to find that number on your card, you may be able to find the number with a simple Google search, but if all else fails, give our office a call. We may be able to help you get in contact with your insurance.

4) Will my first appointment be covered?

If we accept your insurance, that is a good indication that your insurance will pay for the first visit. However, the question is how much of the insurance your insurance will cover, and that is another question that your insurance is alone able to definitively answer. Please give them a call to determine how much your responsibility will be for the appointment. If you’re having trouble finding a number to call your insurance, give us a call! We should be able to find that number for you to call.

5) Do I need a referral/authorization?
Our office doesn’t require you to get a referral from your primary care doctor. However, your insurance may require one, so it is very important that you contact the insurance company to find out for sure. In that regard, if you aren’t able to get the referral prior to your appointment, we will have to reschedule you, so it is very important for you to obtain any referrals your insurance may require.

6) Do I need to bring my referral to my appointment?

There certainly isn’t a problem with bringing your referral to the appointment. However, since our office does not require a referral, there won’t be any problem if you don’t bring a copy to our office. Of course, don’t forget to have the referral sent to your insurance company if they require one in order for you to see a specialist.

7) Will I need a referral or authorization for surgery?

Again, this one will depend on your insurance. We do not insist that you get an authorization, but your insurance may. In that case, our insurance department will contact your carrier in order to initiate that process, and we will contact you if we need anything to complete the authorization. What we may ask of you, though, is a medical clearance. In that event, we will notify you of your need for medical clearance prior to surgery and provide you with a doctor recommendation if you are not already established with a doctor in the necessary specialty.

8) I received a bill from PFI. How will I know whether my insurance has been billed?

This question can only be accurately answered by our insurance department. If you have this concern, please contact our office. If we aren’t able to give you an answer right away, we will contact your insurance company and get an answer for you. Thank you for trusting us with your care.

Be well and stay healthy!