Office Visits
Generally patients with PPO coverage can be reimbursed for all or part of their visit with Dr. Hirani, while patients under HMO plans or Kaiser will not be reimbursed. The amount of reimbursement you receive from your insurance company depends on your specific plan, your co-pay and your annual deductible. Also, many insurance plans impose caps on the amount that a subscriber may be reimbursed for an office visit. Medicare recipients will not be reimbursed because our office does not bill Medicare. You will pay for services rendered by Dr. Hirani at the time of your visit. You may pay by check, credit card or cash. Our office does not bill insurance, however we will provide you with a copy of the superbill which you should submit to your insurance company for reimbursement. The superbill is a detailed medical receipt that contains procedure codes, diagnosis codes, and the fees charged for your office visit. See below for pro forma CPT codes and fees from the superbill that you will receive from our office.
For adults, your initial consultation will be 60 minutes. Abridged consultations are offered and recommended to patients who have a limited number of health issues that can be properly addressed in less time and are only interested in injection or IV therapy. Abridged visits are also recommended to generally health patients seeking wellness and preventative recommendations. Please note, there may not be sufficient time to perform a full physical exam during and abridged visit, but only a partial.
Lab Work
While our office does not bill insurance, almost all of the laboratories that we work with can and do bill insurance on the patient’s behalf. For routine lab work, we will provide you with a requisition form that you will take with you to a convenient LabCorp draw station. For specialty labs not offered by Labcorp, we will provide you with contact information for a mobile phlebotomist that will come to your home. Some specialty labs will require a co-pay in order for them to bill your insurance. Similarly, some specialty labs offer a “prompt pay” discount when you prepay for your lab work, instead of the lab billing your insurance company. In some cases, depending on your insurance carrier and the amount of the prompt pay discount, our office will recommend that you choose the prompt pay option to lock in a lower price. When your results are ready, the lab will send a superbill to you for submittal to your insurance company.
Fees
| Service | Fee | CPT Code(s) | |
|---|---|---|---|
| Initial Consultation Adult 1 hour |
$800* | 99205 | |
| One hour Office Visit | $800 | 99215 | |
| Half hour Office Visit | $400 | 99214 | |
| Lab work | Varies | Varies | |
| *This fee assumes all of your forms have been submitted 7 days in advance, otherwise your fee will be $50 higher.Please be advised this is not a complete list of our services, but only to give you a good faith estimate of your (insurance’s) financial responsibility. Also, please note that if lab work is required, the patient will make financial arrangements (usually insurance) with our laboratory partners and not this office.
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