Insurance is an important part of health care for all of our patients. We want to make sure that you don’t have any stress revolving around your insurance coverage and we have provided information below.
Physician Partners of America (PPOA) participates with most major insurance carriers. Please consult your insurance company or contact one of our scheduling representatives prior to your appointment to verify our participation status with your particular plan.
Office Visit Authorization
Three to five days prior to your appointment, a representative from Physician Partners of America (PPOA) will contact your insurance company to verify eligibility, benefit type, co-pay amount, deductible and any requirements with respect to referrals.
We will make every effort to obtain authorization from your insurance company before you walk into the office. However, please know that despite our best efforts, some insurance companies require you to obtain a referral from your primary care physician before your appointment.
If you are asked to get a referral from your primary physician, this must be done at least three days before your appointment at Physician Partners of America (PPOA). This will ensure that we have the authorization needed before you come in so that there is no delay in your visit with one of our doctors.
If needed, it is important to get this referral because if you arrive for your appointment without it, we may be required to reschedule your appointment.
Authorization for Diagnostic Testing Services
The Clinic Authorizations Department of Physician Partners of America (PPOA) will handle authorizations for all of the tests requested by physicians including tests like MRI, CT and EMG.
Because insurance companies have their own rules regarding diagnostic testing services, a representative from Physician Partners of America (PPOA) will contact your insurance company, your primary care physician or, in the event of a workers compensation claim, the workers compensation adjuster to obtain authorization for the tests requested by the doctor.
Following authorization, you will get a phone call from our representative to schedule the tests.
Physical Therapy Authorization
If you are referred to physical or occupational therapy, our therapy department will reach out your insurance company as a courtesy to verify that your benefits include this kind of therapy.
During this phone call, they will obtain information about coverage, how many visits are allowed under your plan and whether not you have any co-pays.
In cases where authorization is required prior to physical or occupational therapy visits, we recommend that you also get in touch with your insurance company to confirm your benefits and understand any out-of-pocket expenses that may be required of you.
Authorization for Durable Medical Equipment
Physician Partners of America (PPOA) has a bracing department that provides you with braces and supports when ordered by our physicians. For your convenience, patients have a choice of where to pick up these items and they are also generally available at Physician Partners of America (PPOA).
We charge a deposit for each item being prescribed and you will receive an estimated amount of what you will personally be responsible for. If this deposit exceeds the true financial responsibility for braces or equipment, that overage will be either credited back to any open balances you have with us or refunded to you. You will still be responsible to pay any amounts not covered by the deposit including any insurance deductibles that are noted in the patient explanation of benefits.