Thank you for choosing us as your health care provider. The following is a statement of our Financial Policy, which we require you read and sign prior to any treatment. All patients must complete our Patient Information and Insurance form before seeing the doctor. If you are being seen for a personal injury case, you must also complete and sign SCOP’s lien. We accept cash, checks, or Visa/Mastercard.
We will bill your insurance company as a courtesy. It is your responsibility to know your benefits and how they will apply to your treatment by the doctor. If your insurance company has not paid your account within 60 days, the balance will be transferred to you and/or the guarantor listed on the Patient Information form.
We have contracted with your insurance company to provide services at a reduced rate. Your co-insurance is your responsibility and is due at time of your office visit. In the event your insurance coverage changes to a plan where we are not a participating provider, you will be responsible for any out-of-network deductible or coinsurance amounts.
We accept assignment with Medicare. Medicare pays 80% of their allowed amount after satisfaction of the yearly deductible. You are responsible for 20% of Medicare's allowed amount. We will bill your secondary insurance as a courtesy.
Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company's arbitrary determination of usual and customary rates.
All services must be paid in full at time of treatment.
A $25.00 fee will be charged for any returned checks. We will be unable to accept your check for any services thereafter. Thank you for understanding our Financial Policy. Should you have any questions, please contact Evelyn Calderon at 310/337-3700, extension 247.
Our specialists participate with most insurance plans including Medicare. Prior to making an appointment we recommend that you contact your insurance carrier to verify that the doctor you wish to see is contracted with your plan. At this time we do not accept auto insurance or third party insurance.
First Health / Coventry Health
Great West Healthcare
Orange County PPO
Physicians Care of California
United HealthCare / PacifiCare
Blue Shield 65+
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