Insurance

We Accept

  • Blue Cross PPO, Blue Shield HMO/PPO, Cigna PPO, United Healthcare PPO, First Health, Aetna, PERS Plans. We are Champus Tricare Standard providers.
  • Convered California – Blue Cross and Blue Shield “metal” plans – Bronze, Silver, Gold, Platinum. Be aware these plans have high deductibles.
  • Medicare – you are advised to have secondary insurance to cover the 20% of allowable charges and annual deductible that Medicare does not cover. We do accept Tricare For Life as a supplement.
  • Self Pay patients. Payment is required at the time of service.

Each provider is individually contracted with insurance companies. Please contact their office or your insurance company to check for eligibility.

We Are Unable To Accept

  • Medi-Cal including Traditional Medi-Cal, CMSP, CCS, Health & Wellness, Anthem – Exchange Medi-Cal plans.
  • Most “medical discount” cards, including “MediShare” plans – patients may find our self pay rates better value.
  • Beech Street PPO, Multiplan
  • Kaiser – unless has CCN option

Copays & Deductibles

These are determined by your insurer and are payable at the time of service. Please check your plan benefits before you incur charges, our billing staff are happy to help on request on matters relating to our charges, general questions about your benefits should be answered by calling your insurer or employer benefits department.

Workers Compensation & Motor Vehicle Accidents

We are pleased to see our own long term patients for Workers Compensation and Motor Vehicle Accidents. However, to meet legal requirements, we must have full insurance details, claim number, claim address so that we can process authorization before the time of your visit. If these are not available, then your visit will be regarded as a self-pay basis. We cannot bill private medical insurance for these claims since they are generally not covered. We do not accept Workers Compensation cases from carriers that pay under Medicare rates.

Non-Covered Services

Our customer service staff can give guidance with respect to generally covered services with the insurances that we are familiar with. However, it is the patient’s responsibility to check whether services are covered. Many insurers do not cover preventative care. Patients receiving non-covered services such as physicals, employment-related physicals, and vaccinations are liable for the cost at our current fee scale which is available on request. There is a 20% discount for payment at the time of service, except for vaccines. We do charge for completing forms unless they are completed during an office visit and for prescription refills where there has not been an office visit within the last 3-6 months, depending on prescription type. Services provided by telephone, fax or email are generally not covered by insurance and may incur charges.

Internet Services

Administrative services are free. There may be a charge for clinical questions if they do not relate to an office visit within the previous 14 days.
You may also use our E clinical web portal to contact your Pod’s staff. Please note the physicians do not accept questions via the portal, other than for Argyll Advantage patients.

Please do not use email to contact your physician due to the HIPAA law.

Billing

Insurance is billed as a courtesy. If you insurer does not pay for your service within 90 days for any reason (other than official determination of lack of necessity) you are liable for any charges incurred. We will resubmit a claim once if we have been given wrong insurance information etc. It is the patient’s responsibility to inform us of any change of insurance, address, and/or personal details.

Copays and deductibles are payable at the time of service. For your convenience, we accept payment by cash, check, Amex, Visa, Mastercard. Debit cards bearing the Visa or Mastercard logo can be accepted. Bills are mailed immediately after a response is received from your insurer showing a patient balance, and again after 30 days. Since a disproportionate effort  isexpended in trying to collect small amounts from a small number of patients, we have the policy of requiring a CreditPay agreement, this is an agreement to automatic billing to a specified credit card up to a customer specified limit, if you do not pay a bill or contact us about it within 14 days of receiving a second statement. Beyond this, accounts are referred to Butte County Credit Bureau with a collection fee added. Bad Checks incur a $20  fee. After two bad checks, payments will only be accepted by cash or credit card. Our financial customer service staff are happy to assist patients with payment plans in the case of genuine difficulty or need.

We aim to offer electronic bill presentment and payment options in the future.

Insurance Advisor

If you need assistance in choosing insurance or wish to hear about newer options like tax free Health Savings Accounts, please feel free to contact our advisor, Antonette Vanasek,  antonette@vanasekinsurance.com, registered health underwriter and independent insurance agent, who can give advice about a variety of plans.

Insurance And Billing Questions

General Questions: billing@argyllmedical.com
Contracting Policies: drbishop@argyllmedical.com