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Center for Skin Aesthetics | Site Map & Contact Info |
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Center for Skin Aesthetics | Site Map & Contact Info |
Call-in Time: 8:00 AM - 8:45 AM Monday through Friday. The office is open during this hour for the following services:
Appointments
Regular office hours are from 8:45 AM to 4:45 PM, Monday through Friday. These hours are for visits with your provider by appointment only. If you must cancel an appointment, please notify the office as soon as possible so we may offer the time slot to another patient.
We prefer to schedule appointments in advance but we realize that situations arise that may require you to be seen on the day you call. We will make every effort to see established patients with acute problems on the day they call (in such instances, please emphasize to our receptionists that you wish to be seen that day). No-shows or cancellations less than 24 hours before appointments can cause particularly difficult problems for our office. Thus, patients will be billed for the time they had scheduled if they do not appear and have not canceled 24 hours prior to the appointment. Extenuating circumstances will be taken into consideration.
Follow-up appointments are occasionally necessary to allow us to assess efficacy of treatments and to allow us to consider other approaches that might not have occurred to us on the first visit. If you feel that a follow-up appointment is not indicated, please let our office know.
A Notice to Parents with Children
Note: the minimum age for patients moving from a pediatrician is 16.
This is an adult medicine practice and as such our examination rooms contain appropriate supplies and equipment. While we love children, we prefer they not attend your visits with you. If you must bring your children with you, please adhere to the following rules:
Thank you for your cooperation!
Prescription Refills - Charges
General Internal Medicine Group, P.C., has always taken pride in providing the highest standard of care to our patients. We have provided services such as telephone visits and prescription refill calls for patients at no charge as an extension of being under our care. We were happy to provide this service by phone rather than require patients to return to the office for a visit to meet their need. Unfortunately, due to changes in insurance reimbursements we can no longer provide these services as a courtesy. Insurance plans have tremendously reduced the amount of fees General Internal Medicine Group, P.C. collects for services rendered to patients while increasing paper work and administrative burden to an all time high. This office has found it harder and harder to maintain the consistently high level of service we try to provide to our patients because we are simply not reimbursed from the insurance companies to cover the expense of providing certain services.
We have found it necessary to change some policies and charge fees for these services. Effective August 15, 2000 the following changes will be in effect:
Prescription Refill Telephone Requests
There will be a charge for prescription refills authorized
or written at any and all times other than during a normally scheduled
follow up or urgent care office visit. This includes any prescription
that needs to be called, faxed, or mailed to any pharmacy provider.
To avoid these charges you should request that all of your prescription
needs are part of your regular visit with your physician. The
physician will make every effort to provide long-term prescriptions
and automatic refills without the need to contact the provider
for refills. Prescriptions that need to be rewritten because of
a pharmacy benefit provider changes will be charged to the patient.
Charges for prescription refill calls are as follows:
Level I Prescription Call--------$15.00 (1-3 prescriptions)
Level II Prescription Call-------$25.00 (4-6 prescriptions)
Level III Prescription Call------$35.00 (7+ prescriptions)
Telephone Visit Calls
Our physicians and physician assistants make themselves available
8:00 and 8:45 AM to take calls directly from patients concerning
illness or abnormal lab results. Our patients tell us they greatly
value this service. We will continue to provide this service at
no charge for calls up to three minutes. For calls
that require more than three minutes the following
charges for the telephone visit will apply.
After hours and weekend calls resulting in telephone treatment
will be billed a telephone visit.
Level I Telephone Call--------$30.00
Level II Telephone Call-------$45.00
Level III Telephone Call------$60.00
We will file these charges with your insurance carrier. If it is determined that these services are non covered by the patient's insurance plan, we will bill directly to the patient. Patients are responsible for any balance not paid by their insurance for this service.
These services are not routine, but are added clinical and administrative services that General Internal Medicine Group performs as a convenience and time-saving benefit to our patients. We hope that these extra convenience services continue to be a value to our patients.
We prefer that you coordinate all your prescription refills during regular routine office visits. However, we are available to authorize appropriate prescription refills from 9:00 AM to 5:00 PM Monday through Friday by calling the office. We prefer that you call a few days before your prescription is needed.
Refills may also be handled by contacting your local pharmacy, who in turn will call us to refill the request.
For local pharmacy refills, please make sure your message includes:
Mail Order Prescription Refills
Many of our patients participate with mail order prescription plans. We have always tried to work with these plans on behalf of our patients. However, several of these plans have adopted policies and procedures which place too much demand on our staff's time and takes them away from patient care. These changes include: burdensome paperwork to fax prescriptions, refusing to contact us regarding prescription refills, keeping our staff on hold on the telephone for very long periods of time to phone in refill in formation, and refusing to accept prescription transfers from local pharmacies. We have thus implemented the following policies:
Any time a physician gives a prescription to a patient at the time of the visit, we do not also call in or fax it into the pharmacy, since this again takes away from our staff's time from patient care.
Your medical care through General Internal Medicine Group does not stop when our office closes. By calling our office at (703) 525-8863 or (703) 573-9800, you will be able to reach us 24 hours a day year round. You may leave a message we will get the next working day or you may leave a message on our emergency line that we will receive within approximately 15 minutes. Please follow the computerized answering service directions closely.
All routine matters should be handled during regular office hours. However, a physician from our group can be reached at all times. If you believe your situation is critical, always go to an emergency room or the nearest medical facility and ask the physicians there to contact our office. Otherwise, call our office first before going to a clinic or emergency room - many problems can be handled over the telephone.
Lab Communicator (Test Results)
General Internal Medicine has a dial in system that allows you to access your test results at your convenience, 24 hours a day, 7 days a week. This is an automated system that records your medical provider's personal and confidential message to you. Please follow the instructions below to retrieve your personal message. Once you have dialed in to the system there are voice prompts to guide you. You will need your social security number.
The recorded message is saved for 5 days after you first listen to the message so you may call back if you need to. If your provider prefers to speak directly to you regarding the results, he/she will leave a message asking you to call the office.
Laboratory results will be available four business days following your appointment, except pap smear results which are ten days following your appointment or if you are otherwise instructed to call at a specific time. We no longer mail lab results.
Any other test results (x-rays, mammograms, CT or MRI scans, sonograms, etc.) will be available 7-10 business days after the date your test was performed.
Critical test results will not be left on the Lab Communicator. We will contact you directly.
Today's health insurance policies and coverage offer more options (and confusion) than ever. Each patient is responsible for knowing his or her plan's benefits package, co-payment, deductible, non-covered services, and restrictions. Many plans have participating or preferred Practitioners. We participate in most area health plans.
Note: we
are not accepting new Medicare patients as of January 3, 2006
We are in the application process for other plans. Check with us if your plan is not listed above.
Note:
We are not accepting new Medicare patients as of January 3, 2006.
We do not participate with Healthkeepers, the HMO for Anthem Blue Cross/Blue Shield.
We do not participate with Tricare/CHAMPUS .
Effective September 17, 2005, we will no longer be participating with First Health and all affiliated products that include the CCN network, Mailhandlers and Colonial Insurances. We are happy to continue to see you as our patients. We will continue to bill your insurance as a courtesy. You will be responsible for the entire amount your insurance does not cover. You should contact your insurance company to determine how this may affect you.
Q: Does this mean that General Internal Medicine Group can no longer be my doctors?
A: General Internal Medicine Group can continue to be your doctors and we hope you will continue with our practice. Most plans have coverage for patients who see doctors not in the network or participating with the plan. This is called "out of network" benefits. Patients who have out of network benefits may have to pay deductibles and co-pays for services by a non-participating provider. Patients should consult with their plan about their out of network benefits.
Q: Why has General Internal Medicine Group terminated its participation with these plans?
A: General Internal Medicine Group notified the health plans that participation was being terminated due to low reimbursement rates. The reimbursement rates being paid in some cases have had no increases in years. All are paying less than Medicare for our most usual services. The plans were notified that we would consider continuing if the reimbursement rates were adjusted upward to a satisfactory level. Some plans we notified have already increased their reimbursements so we have continued to participate with those plans. The plans we are terminating have not negotiated increased reimbursements.
Q: If the above health plans offered satisfactory reimbursement rates, would General Internal Medicine Group continue to participate?
A: We have made it clear to the health plans that we would continue to participate if satisfactory reimbursement rates could be negotiated.
Q: Is there something I can do?
A: Yes. You can speak to your employer's benefits manager in the Human Resources department. Since they are the ones negotiating your health insurance coverage, they can contact your insurance company and let them know what happened. If enough employees bring this issue to their attention, the insurance company may be willing to negotiate with us.
We are sorry for any inconvenience this may cause you. Please let us know if you have further questions.
Sincerely,
The Practitioners and Physicians of General Internal Medicine Group
Because insurance and Medicare billing have become tremendously complicated we utilize a billing office that is separate from our medical office. If you have questions concerning your bill at the time of your visit, please confer with our receptionist after your appointment is concluded. If you have questions concerning payment of your bill after you leave our office, it is best to communicate with the billing office.
We believe our office fees are reasonable and our patients find their out-of-pocket expenses to be minimal. Thus, we expect all accounts to be paid promptly. If you are unable to pay your bill in a timely manner, please contact the billing office so we may work out a mutually acceptable payment plan. We make every effort to work with our established patients so they may continue to receive care through our office regardless of their ability to pay. But unless arrangements are made, we will turn over any unpaid accounts to a collection agency.
PPO: Some PPOs require subscribers to select a primary care physician and to have a referral from that physician before seeing any specialist. PPO subscribers are given a Directory of Preferred Practitioners who are plan participants (subscribers may have an option to see doctors who are not in this network of Practitioners, but the option will be at a different benefit level). PPO policies usually require a co-payment by the patient that is due at the time of each visit. The co-pay amount appears on your insurance card. We will collect your co-payment and bill your PPO plan. After the claim has been processed, we will send you a statement for any balance due from you. If your PPO does not have a co-pay, we will file with your plan and send you a statement for any balance due.
HMO: HMO plans require that patients have a primary care physician who is on the HMO list of doctors. HMOs also require a referral from your Practitioners before you can seek health care (including X-ray, lab, or specialty services) from any other provider. If you seek such care on your own, we will not provide referrals. We are not allowed to provide retroactive referrals. A co-pay due at time of service is required for every visit. There may be services that are "non-covered" by your HMO and you should be familiar with those. If any non-covered service is provided, payment is due at the end of your visit.
Indemnity/Commercial Insurance Plans: For patients with such coverage, we collect 20% or 30% of charges at the end of your visit and file a claim with your plan on your behalf. Because you are ultimately responsible for payment, you should contact your plan if it does not pay your claim. You will receive a statement from us until the account is paid in full.
For patients without insurance coverage, payment is expected at the time of service unless other arrangements are made in advance.
Medicare (Link to Medicare.gov)
Note: we are accepting new Medicare patients as of May 1, 2008.
We list Medicare separately because it is such a complicated and confusing program. As participating Practitioners, we accept Medicare's allowable charges and write of any non-allowed charges. Medicare pays 80% of allowable charges, excluding lab fees. The patient is always responsible for the annual deductible and the 20% co-insurance amount not covered by Medicare. Supplemental insurance plans (Medigap) pay for co-insurance and the deductible.
We file all your Medicare claims for services rendered in our office. Patients must not send their own claims to Medicare. Our reference lab will bill Medicare for all your lab tests it conducts. Please inform us if you have secondary (Medigap) insurance; Medicare may coordinate with or "cross cover" to your secondary insurance carrier. If we participate with your Medigap plan, we will file all claims for you. If there is a balance due, you will receive a statement from us.
Please recognize that Medicare only covers selected tests considered preventive health screening. Medicare may not pay for some regularly performed tests if it determines that those tests do not meet Medicare's guidelines.
Medicare.gov - Health Information Overview including covered preventive examinations
If you have questions regarding payments for tests, please confer with us. We perform only those tests we consider medically appropriate and necessary.
General Internal Medicine recognizes the needs of patients who may be uninsured, have high deductibles, no coverage for preventive health examinations or the advantage of a flexible healthcare spending account. We have designed our "cash payment" fee schedule to meet the needs of these patients so they may be provided with healthcare at a reasonable cash rate.
Payment is required at the time of service. To be eligible for these rates, payment is required at the time of service, and General Internal Medicine will not file a claim with insurance.
| CPT Code | Usual Fee |
Cash Rate |
|
| New Patient Office Visits | |||
| 99202 | Level 2 (brief) | $109.00 |
$88.00 |
| 99203 | Level 3 (intermediate) | 156.00 |
130.00 |
| 99204 | Level 4 (extended) | 225.00 |
183.00 |
| 99205 | Level 5 (comprehensive) | 288.00 |
231.00 |
| Established Patient Office Visits | |||
| 99211 | Level 1 (Nurse/Medical Assistant Only) | 38.00 |
30.00 |
| 99212 | Level 2 (brief) | 62.00 |
53.00 |
| 99213 | Level 3 (intermediate) | 88.00 |
72.00 |
| 99214 | Level 4 (extended) | 138.00 |
112.00 |
| 99215 | Level 5 (comprehensive) | 200.00 |
161.00 |
| Preventive Health Services (i.e. physicals, well woman exams) | |||
| 99385 | New Patient, age 18-39 | 218.00 |
165.00 |
| 99386 | New Patient, age 40-64 | 250.00 |
185.00 |
| 99387 | New Patient, age 65 and over | 281.00 |
200.00 |
| 99395 | Established Patient, age 18-39 | 188.00 |
135.00 |
| 99396 | Established Patient, age 40-64 | 218.00 |
155.00 |
| 99397 | Established Patient, age 65 and over | 238.00 |
180.00 |
| 93000 | Electrocardiogram (EKG) | 50.00 |
50.00 |
| Laboratory Services | |||
| 85025 | CBC (Complete Blood Count) | 20.00 |
15.00 |
| 80054 | CMP (Comprehensive Metabolic Panel) | 25.00 |
25.00 |
| 80061 | Lipid/Coronary Risk Panel | 40.00 |
30.00 |
| 82270 | Stool blood testing, single specimen | 5.00 |
5.00 |
| 84153 | PSA (Prostate Specific Antigen) | 50.00 |
50.00 |
| 88142 | Pap smear, Thin Prep | 65.00 |
65.00 |
| 86701 | HIV (human immunodeficiency virus) screening | 35.00 |
35.00 |
| Additional Screening Exams that maybe useful prior to exercise or to assess fitness | |||
| 93015 | Screening exercise stress test for cardiac fitness and disease | 300.00 |
275.00 |
| 93307 | Echocardiogram for cardiac function analysis | 541.00 |
400.00
|
| 93320 | |||
| 93325 | |||
Preventive Health Exam - Recommended Standard Testing
Standard recommended exam and testing - additional tests may be recommended based on your health or family history. Your provider will discuss any additional testing with you prior to ordering additional test. Charges for the exam vary slightly by age of patient. Check the fees above for the preventive exam fee for your age.
| Preventive Health Physical average costs,
New Patient age 40-64
|
||
| Includes: | Examination | $185.00 |
| 85025 | CBC (Complete Blood Count) | 15.00 |
| 80054 | CMP (Comprehensive Metabolic Panel) | 25.00 |
| 80061 | Lipid/Coronary Risk Panel | 30.00 |
| 82270 | Stool blood, single specimen | 5.00 |
| 88142 | Pap smear, Thin Prep - female | 65.00 |
| 84153 | PSA - male, when indicated | 30.00 |
| 93000 | EKG | 50.00 |
Total Male: $340.00 |
||
Preventive Health Exam average costs,
Established Patient age 40-64
|
||
| Includes: | Examination | $155.00 |
| 85025 | CBC (Complete Blood Count) | 15.00 |
| 80054 | CMP (Comprehensive Metabolic Panel) | 25.00 |
| 80061 | Lipid/Coronary Risk Panel | 30.00 |
| 82270 | Stool blood, single specimen | 5.00 |
| 88142 | Pap smear, Thin Prep - female | 65.00 |
| 84153 | PSA - male, when indicated | 30.00 |
| 93000 | EKG | 50.00 |
| Total Male: $310.00 Female: $345.00 |
||
As primary care practitioners, it is our job to determine when our patients need to consult with a specialist. The Practitioners in this office have specific specialists whom they know and trust to provide excellent care to our patients. If you need the care of a specialist, your provider will select a specialist who s/he knows and is also in your health plan.
Each plan limits the number of visits that may be authorized on one referral and sets a specific time frame in which the first and subsequent visits (if any) must occur. You are responsible for knowing your plan's referral requirements and specific restrictions to assure you are in compliance.
If your referral is for an urgent medical situation, the referral will be processed immediately. The definition of an urgent situation is one that would cause significant bodily harm if a referral is not processed immediately.
Because of added administrative work we must perform with your health plan, all non-urgent referrals are processed and mailed to you within 3-5 business days. Our referral coordinator will contact you if there are any questions or concerns. Otherwise, you should expect your referral to be mailed to you in the above stated time frame.
You are responsible for taking the referral to the specialist. You should not schedule your specialist appointment until your provider has approved your referral and the coordinator has had time to process and mail it (approximately 5-7 days including mail delivery time). Please do not call to check on your referral until processing time has passed. Afterwards, you may call the referral coordinator at (703) 573-8604.
Some insurance plans require 5-7 days after the request by the provider to give authorization for referrals including nutrition counseling, sleep studies, infertility, hemodialysis, outpatient infusion, hyperbaric oxygen, ongoing referrals involving a case worker, or a non-participating facility.
There is a $10 replacement fee for lost referrals.
We do:
We cannot:
Our office has contracted with Smart Corporation
scanning service
to scan and transfer your medical records. All fees are based on Virginia State
Rates, Virginia Code Ann. 8.01-413. Base fee is $10.00 plus $.50 for each page,
for the first 50 pages, and $0.25 for each page after 50. Smart Corporation
will invoice you directly.
A separate signature is required for release of HIV/drug/alcohol/psychiatric information.
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Center for Skin Aesthetics | Site Map & Contact Info