How to Establish Care
Establishing care at AllCare is only considered after careful review of all old medical records, diagnostic tests (ie: procedures, mammograms, etc.) sub-specialist records and any other pertinent medical records.
Walk-in visits DO NOT constitute the establishment of care.
Certain patient cases will not be considered for establishment of care, as these conditions require a multidisciplinary setting for effective care:
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- Chronic pain
- Active or relapsing drug and alcohol abuse
- Active or relapsing eating disorders (ie: bulimia or anorexia)
Our New Patient Intake forms must be completed in detail and signed, with your records being obtained prior to an initial consultation visit being scheduled. We strongly suggest you contact your past doctor(s) and verbally request your old records to expedite our receipt of all requested documents.
Walk-in/Emergent Care
The AllCare walk-in facility provides effective, convenient and reasonable care for those who do not have health insurance. AllCare treats certain common conditions
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in our walk-in facility. Both established and non-established patients are welcome to walk-in without an appointment, as we are open six days a week.
Conditions that our walk-in facility treat:
- Sinus infections or upper respiratory infections
- Bladder infections
- Strep throat
- Pink eye or styes
- Minor injuries, such as burns, sprains, lacerations/cuts
- Skin conditions, such as warts or eczema
- Bug bites, animal bites
- Flu shots
- Tetanus vaccinations
- Routine physicals for school or work
- Pregnancy tests
Please call ahead if you are unsure if you can receive care for your condition. Non-established patients with HMO insurance coverage must call their insurance carrier for appropriate referrals to urgent care facilities. Additionally, there are age restrictions on who can be treated for certain conditions. Call AllCare at 480-941-4400 to find out more information.
Understanding your Explanation of Benefits (EOB)
It’s important you understand terms like copayment, deductibles, co-insurance and other terms used in your explanation of benefits.
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Here are explanations of terms you’ll need to understand:
What is a copayment?
A copayment or copay is a pre-determined dollar amount that you are required to contribute towards the cost of a doctor visit, prescription medication and other covered services. Sometimes your plan will include different copay amounts for different services. For example, the copay for a visit to your primary care physician (PCP) may be $25, while the copay amount to visit a specialist may be $35.
What is a deductible?
Some services covered under your health insurance plan are subject to a deductible. A deductible is the amount you pay out of your own pocket for covered services each year before your insurance carrier starts to pay. For example, if you have a $1,500 deductible, you are responsible for paying the first $1,500 in covered health care costs.
Family vs. individual deductible?
Plans may have both a family deductible and an individual deductible. The way those deductibles are met can be different. It depends on the type of plan you have. Some plans have what is known as an “aggregate” deductible. This means that when you pay for an expense, the payment is applied to both the individual and family deductible at the same time.
For covered services subject to the deductible, your plan starts to kick in when you meet your individual deductible or your family meets the family deductible. Each family member contributes to the family deductible until his or her individual deductible is met. For instance, if one member of the family has met their individual deductible, future medical expenses would not be applied to the family deductible because this family member would have already met their individual deductible.
Some plans have “per member” deductibles. This method includes the individual deductible but there is no set family deductible amount. Instead, once a certain number of family members (usually two or three) meet their individual deductibles, the plans starts covering expenses for all family members.
What is coinsurance?
Once you have met your deductible, your plan picks up most of the eligible costs. You pay only a percentage of the costs, which is referred to as coinsurance. For a plan with 20% coinsurance, your insurance carrier pays 80% of the covered expenses while you pay the remaining 20%. The amount of coinsurance you pay can vary depending on whether or not you use an in-network provider.
What are in-network providers?
In-network providers are doctors and other health care professionals who agree to provide services for a negotiated set of fees. The negotiated fees may even be less than what the provider would normally charge.
For out-of-network providers, your insurance carrier pays a percentage of the “reasonable and customary” cost for that service. If the doctor’s bill is above the “reasonable and customary” amount, you are responsible for paying the difference in addition to your percentage of the coinsurance. When you receive care from an out-of-network provider, you typically will pay a higher rate of coinsurance.
What is an out-of-pocket maximum?
An out-of-pocket expense maximum, or cap, is the maximum amount that you have to pay in a plan year. After reaching the maximum, your insurance carrier will pay for all covered services – up to the plan’s lifetime maximum – for the remainder of the year. It is important to know what type of expenses can be applied toward this maximum amount. For instance, payments towards your deductible and coinsurance can be applied. However, your monthly plan premium would not be applied towards satisfying the out-of-pocket maximum.
Self-Pay Discounts and Payment Plans
AllCare Internal Medicine is currently accepting new patients and accepts most insurance plans. Please phone us directly for more information on your insurance plan.
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For those patients without insurance coverage, AllCare offers self-pay discounts and payment plans, which are arranged on a patient-by-patient basis. Call our office directly for additional details.