ACCEPTED HEALTH PLANS
We are contracted with most major health plans in the area. Certain plans may require a pre-authorization request to be filled out by your primary care provider. Please have your membership card available when calling to schedule appointments.
FREQUENTLY ASKED QUESTIONS:
Question 1: How does your office handle co-pays, deductibles, and co-insurance?
- The amount of co-pay, deductible, and co-insurance is set by each insurance company and were are contractually obligated to collect that amount. While some health plans require co-pays for office visits only, other health plans require co-pays for both office visits and procedures.
- Our office policy is that a patient’s co-pay, unmet deductible, and co-insurance are due and collected at the time of service. Before a service is rendered, our staff will verify your eligibility and determine your financial responsibility for that visit. This amount varies between patients and health plans, and we base it on your individual policy and our contracted rates. A payment to our office can be made in the form of Check or Cash.
- Co-pays, deductible, and co-insurance are collected on any visit (including follow-ups) with face-to-face time with the doctor which includes assessing a patient’s clinical course and symptoms since the previous visit, physical exam, review and explanation of recent studies, formulating an assessment and treatment plan, counseling, adjusting medications if needed, and generating a clinic note which is sent to the referring doctor and made available to the patient.
- If a patient does not wish to have a face-to-face follow-up visit with Dr. Nguyen after diagnostic tests are completed, reports of any tests that were ordered will be provided to the patient upon request and copies of results sent to the referring doctor (generally the primary care doctor) who will go over the results and provide counseling to the patient.
- Once your insurance company sends our office payment for your care, they will also send you an EOB (explanation of benefits) that will describe what medical treatments/services were paid on your behalf. It is also very important that you review this document and let us know if any over-payment was made so that your refund will be processed in a timely manner. We have seen rare cases where a patient’s co-pay, co-insurance, or deductible changes between initial visit and follow-up visits so it’s very important for the patient to bring to our attention any errors.
Question 2: I recently signed up for Covered California. Will I be able to schedule an appointment with you, Dr. Nguyen?
- Our office can see patients with HealthNet Covered CA Exchange if their plan is an HMO plan administered through a medical group that we already have a contract with, such as ADOC or Regal. If you have a HealthNet plan and you select ADOC or Regal as your group, your primary care provider will most likely be able to refer you to our office. We are unable to see HealthNet PPO patients.
- Our office can see BlueShield Covered California PPO.
- Our office can see patients from Anthem Blue Cross Covered California PPO/EPO.
Question 3: If I don’t see my medical group listed above, how can I select Dr. Nguyen as my cardiologist?
- If you are a patient with a commercial health plan, Medi-Cal, Medi/Medi, or Medicare and are not part of a health plan that is accepted by Dr. Nguyen, please discuss the issue with your primary care provider to help you select another health plan/medical group plan that is contracted with Dr. Nguyen.
Question 4: What is your office policy for scheduling new visits, procedures, and follow-up visits?
- Our office has two independent appointment schedules, one for procedures and the other for clinic visits with the doctor.
- Office procedures include Holters, Echocardiograms, Stress tests, and Vascular Ultrasounds. Patients should show up to procedures 5 minutes before their scheduled time. If patients show much much earlier, they will not be able to do the procedure earlier and have to wait until the previous patient completes their studies. If patients arrive more than 15 minutes after appointment time for a procedure, their procedure will be cancelled. There are no walk-ins for office procedures. Please set aside 1-1.5 hours from the time you arrive and register to completion of an echocardiogram, stress test, or vascular ultrasound.
- Clinic Visits: Both new clinic visits and follow-up visits are scheduled on our appointment calendar at pre-determined time slots throughout the day. However, our open-door policy of allowing walk-ins and accommodating patients who urgently need to to be seen means than patients who have previously scheduled an appointment may not be able to immediately see the doctor upon arrival. The wait time for routinely scheduled visits can be 30 minute to 1.5 hours, depending on the volume of add-on patients.
- Walk-ins and Urgent Visits: The wait time for walk-ins and urgent visits is generally 1-2 hours. If you have an emergent issue, we advise that you to go to the nearest hospital emergency room for arrival.
- Summary: Our office is one of the few cardiology offices in the area with an open-door policy that allows walk-ins, same-day visits, and urgent visits within the same week. This is a service that we provide to our loyal patients and referring doctors to ensure that patients are evaluated in a timely manner, avoid costly emergency room visits, and allow for expedited pre-op cardiovascular evaluations. This service also means that patient who had scheduled appointments in advance may still have to wait a short time after their arrival due to urgent clinic visits or complicated patients that require extra time. Before scheduling an appointment with our office, we hope you will understand adjust your plans accordingly.