Insurance


Beverly Hills Internal Medicine welcomes all patients to our practice. We are not “CLOSED” to anyone!

Make Appointment

Certain insurance companies do not necessarily contract with this office; however, it is important factor to realize is that Medical Insurance is a contract between the Patient and the Insurance Company regarding the financial responsibility for payment for medical services provided by a doctor, or other medical facility.  Remember, it is the patient’s responsibility to confirm insurance coverage prior to a visit/procedure/lab work, etc.

Our office staff is happy to assist you by calling your insurance company to clarify these concerns prior to your visit.  Many insurance companies provide various “plans,” and some of these plans cover preventative care including Annual Physicals, and unfortunately, others plans do not.  Furthermore, certain plans cover the annual physical with no deductible; even though there may be a deductible which may apply to other services provided at the same time the physical is performed, so always ask if you have additional needs at your annual physicial.  Finally, certain plans will fully pay for the clinical examination by a physician, but may apply a deductible for routine laboratory and radiology services.  Thus, the best way to prevent surprises is to be well informed about your coverage prior to your appointment.

We realize that some of the words and phrases used in healthcare can be confusing and have provided a quick reference guide for your use. Click here for Understanding Healthcare and Managed Care Terms *

Please note that payment is appreciated at the time services are rendered.

If you are concerned or have a question about whether your insurance is accepted, you may call your insurance company and ask to speak with your benefits coordinator (number should be on your insurance card) OR contact our office prior to your visit/procedure/lab work, etc. OR visit the website of your insurance provider, as they may have the information readily available.

Several of the “plans” from the following preferred providers are accepted at Beverly Hills Internal Medicine.  The managed care plans (HMOs) must be through UCLA Medical Group OR Cedars Sinai Health Associates and have a Beverly Hills Internal Medicine physician listed as the Primary Care Physician.

Understanding Healthcare and Managed Care Terms

We realize that some of the words and phrases used in healthcare can be confusing and have provided a quick reference guide below.

Capitation

The insurance company pays physicians or medical groups a certain amount each month for each patient.

Co-payment

The fixed amount of money the insured person pays each time he or she sees a doctor, gets a prescription, or has a medical service rendered. Typical in HMO plans.

Co-insurance

The percentage of the total fee the insured person pays each time he or she sees a doctor, gets a prescription, or has a medical service rendered. Typical fee-for-service plans such as PPOs.

Enroll

A term to describe the process of signing up with a managed care health plan.

Fee For Service

Paying for medical services when they are provided or when a bill is received. Payment can be in cash or as an insurance reimbursement.

HMO Plan

A benefit plan in which you must chose a primary care physician and you must use the physicians who are signed up with that group and HMO for any care or the HMO will not pay for the care.

Independent Physician Association (IPA)

An organization in which private-practice physicians agree to work together to negotiate with insurance companies but the physicians run their own offices.

Managed Care

A concept of overseeing the use of medical services to keep the cost of providing care low while at the same time keeping the quality of the care high, typically by having the patient go through a primary care physician before seeing specialists, thus ensuring the proper use of specialty care.

Medicare

A government-funded insurance program that covers people over age 65 and some people with certain diseases or disabilities.

Member

A person who has signed up with a managed care health plan.

Medical Group

A group of physicians who have created an organization devoted to providing medical care.

Open Enrollment

A period of time in which a person can change insurance plans offered by his or her employer.

Out of Pocket

Any fee paid by the patient; can be a co-payment, deductible or the entire bill.

Point of Service (POS) Plan

Members have an HMO and a PPO option. When you need care, you choose to activate either the HMO or PPO option.

Preferred Provider Organization (PPO) Plan

The insurance company will give you a list of physicians you can go to and still be covered; if you go to a physician outside of that list, the insurance company might pay for some of the care, but will usually require you to pay a larger amount.

Primary Care Physician

A doctor who coordinates the care for a person with managed care insurance. All managed care insurance plans require members to choose a primary care physician or medical group before seeking care.

Referral or Authorization

What the primary care physician writes if you need specialized medical care.

Please don't hesistate to call

(310) 657-8585
Questions?