Billing FAQs

What insurance do you accept?  Our office works with most insurance plans, including Cigna, Aetna, Regence, Premera, United Healthcare, First Choice, VA and Kaiser Permanente.  Please call your insurance to confirm that Dr. Jinwah John Hoy, podiatrist, NPI number 1104820653, is on your insurance plan.  We accept Medicaid if it is secondary to another plan such as Medicare or a private insurance.

How do insurances commonly work?  There are many different insurance plans.  Most insurances do not pay for all aspects of care.  There are many ways insurance companies work to control costs, including:

  1. Require a copay for office visits.  The “office visit” is the evaluation and management plan, or face-to-face consultation, with the physician.
  2. Require a referral from your primary care physician.  HMO plans give the patient one primary care physician, and the patient needs to obtain a referral for any specialty care.
  3. Require satisfaction of a deductible before the insurance kicks in to pay anything.  This deductible can be as high as $6000.  It can apply to a whole visit, or anything outside of the “office visit” described above.  That means any x-rays or procedures are subject to the deductible.  A procedure can include an office surgery such as an injection, biopsy, removing an infection or skin lesion.
  4. Require a coinsurance after the deductible has been met.  This is a percentage the patient has to pay.

It’s not possible for us to be aware of all the requirements and benefits for each and every insurance plan, only what the insurance company publishes on verification sites.  You are responsible for understanding the terms and conditions of your insurance benefits, as well as keeping up-to-date on changes to your insurance plan.  Please let us know of any insurance changes, or have any questions about your insurance coverage, well before your appointments.  If we are unable to verify your insurance benefits by the time of your appointment, we will not be able to accept your insurance.

Do I need a referral?  If required by your insurance plan to see a specialist, please contact your Primary Care Physician for a referral.

How does the billing work in your office?  Our team is trained, certified and experienced in insurance, billing and coding.  We do the legwork to find out as much as possible how your insurance works and collect upfront, instead of doing nothing and surprising you with a full bill later.

We verify eligibility and benefits and collect at the time of service.  We check for eligibility, copays, deductibles, co-insurances.  If you’re responsible for any copays and/or deductibles or co-insurances, you’ll be expected to pay them at time of service.

Copays are a fixed amount; deductibles and coinsurances are estimated amounts. Also, payment in full is expected for those who are private pay or do not have a referral.

Patients should be ready to pay at the time of service if they have a deductible, no referral or uninsured.  In these cases, $75 is due for new patients and $25 for established patients before being seen by Dr  Hoy, with the remainder due immediately after treatment is rendered.  Deductibles and coinsurances are estimated amounts, are subsequently billed to the insurance, and, depending on the insurance company allowable, there may be additional billing or refunds applicable.

We will bill your insurance, so you’ll get credit for them. For example, if your insurance has a $5,000 deductible and you have only met $100, and your visit is estimated to cost $200, you’ll be expected to pay that $200 before leaving the office. If after the claim goes through your insurance and the allowable is $205, you will receive additional billing for the $5; if it is $195, you may request a $5 refund.

How much will the visit cost?  Please check this page to learn about how a medical bill is generated.

Do you have payment plans?  Payment plans can be arranged by calling the Billing Department upon receipt of any bill.

“Ava and Dr. Hoy were very professional and friendly. My experience was very smooth and stress free. Ava works with your insurance company to figure out your coverage and Dr. Hoy is a bright smiling face. His exams are very thorough and you leave with a solid plan of action!” -Gabrielle A.