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HEALTH INSURANCE

PRIMARY CARE

Open to all Established Patients, including those who have been previously assigned to us.

AVIATION / IMMIGRATION

Regardless of insurance (including no insurance, military, Kaiser, or any insurance listed below), we are available for Aviation and Immigration medical examinations.

IN NETWORK

  • PPO

  • Medicare Advantage HMO

We are contracted In Network with the following insurances:

  • excludes HPN + tandem

  • includes Full PPO Network

  • HMO only

  • part B

  • Medicare Advantage only

WORKERS' COMPENSATION

  • established patients only

  • requires insurance prior authorization

INSURANCE CHANGE

For Established patients, we are open to all of the above health plans.  Please read below regarding the timeline regarding the importance of planning ahead.

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PLAN TYPES

PREFERRED PROVIDER ORGANIZATION (PPO) PLANS

With PPO plans, no Primary Care Provider (PCP) is mandated, however it is important to have a PCP for optimal quality care.  With PPO plans you can self refer and if you do, inform us so we can coordinate care and exchange information with the specialist.  


We are closed to New patients for some plans so please see above for details.  For Aviation or Immigration medical examinations, if we are contracted with your insurance then we will still bill them on your behalf.  If you are already established with us, we are loyal and will continue you care no matter what plan you choose.

HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS

Managed Care

Managed Care health plans such as Health Maintenance Organizations (HMOs) require that you designate a Primary Care Provider (PCP) in an affiliated medical group.  PCP = Dr. Sunita Shailam in Mercy Physicians Medical Group.

MANAGED CARE PRIMARY CARE PROVIDER CHANGE TIMELINE

If you are our established patient and have changed insurance with automatic assignment to another doctor, you may switch back to us.  As soon as you get your new insurance, call them because it takes time to for a PCP change to be effectiveIn order for our patients to not get stuck with a bill, we do not accept incoming same month transfers. 

TRANSFER REQUEST

Date of Request                  Date Effective

1st-14th of the month      -> Effective the following month on the 1st

15th-31st of the month    -> Effective in two months on the 1st

If you call before the 15th of the month it will be effective the following month and if you call after the 15th of the month you have to wait until the 1st in 2 months.  For example, if you call 14 August it will be effective 1 September and if you call 15 August it will be effective 1 October.  Plan in advance because we do not accept same month transfers.

HEALTH INSURANCE OPTIONS

SECURE BILL PAYMENT

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