Insurance Information

Insurance

• Explanation of billing and prior authorization

  • We bill insurance under the medical side and not the pharmacy side.

  • We cannot accept medication from outside pharmacies. There are specific exceptions to this rule, when we are working directly with the manufacture.

  • For Medicare patients we bill under part b and when there is a supplemental then the supplemental will pick up the 20% patient responsibility. We cannot bill under part d.

  • Medicare patients do not require authorization since we bill under part B

  • Straight medi-cal may require authorization please contact medi-cal or our office to verify if auth is needed.

List of insurances we accept:

• Aetna - all commercial and Medicare PPO

• Blue Cross - all commercial, covered CA, Medi-Cal Managed Care and Medicare PPO

• Blue Shield - all commercial, covered CA and Medicare PPO

• Beech Street - all commercial

• Cigna/Great West - all commercial

• First Health/Coventry/CCN - all commercial

• Foundation - all commercial and self-funded plans

• Health Net - all commercial, covered CA, Medi-Cal Managed Care and Medicare PPO

• Humana - all commercial and Medicare PPO

• Key Medical - all plans (Blue Cross, Blue Shield, Health Net, United Healthcare HMO and Humana Medicare Gold HMO)

• Medi-Cal & CCS

• Medicare

• Multiplan - all commercial

• Networks by Design - all commercial

• Tri-Care - all plans

• United Healthcare - all commercial and Medicare PPO

• LOA/single case agreement required for non-contracted insurances

Insurance(s) we do not accept:

• LaSalle - Medi-Cal Managed Care only

If your insurance is not listed above please call and see if we can accept your insurance with additional agreements that will need to be coordinated by your doctor's office.