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Internal Medicine of Arizona

FAQs

Coronavirus Information (COVID-19)

https://www.cdc.gov/coronavirus/2019-ncov/index.html

Coronavirus Information (COVID-19)- VACCINE

https://podvaccine.azdhs.gov/

Can I get rapid COVID-19 testing done at your office?

We are now offering daily Rapid Testing ($60) as well as PCR testing ($125) for COVID-19 at our satellite office. We result via email. If you are an established patient with an order from one of our physicians, we will bill your insurance. Established patients and non-established patients without a doctors order will be charged for the test at the time of service.  Sign up for testing via the link SIGNUP GENIUS.

How do I get to your office?

Please click here for directions.

Where do I download new patient forms?

Please click here for new patient forms.

How do I refill my existing prescription?

Call your pharmacy and they will fill your order or if no refill prescriptions exist the pharmacy will fax your doctor a prescription request, he will review it, sign if acceptable and be returned to the pharmacy. The pharmacy will then contact you to pick up the prescription within 24 hours.

I am having my labs done at your office. Do I need to fast before my appointment?

Please click here for more information on lab services.

Which Insurance plans do you take?

Please click here to see our insurance page.

Billing Questions?

For billing questions, or to make a payment, please contact our billing department:
Phone: (480) 801-7707
Email: info@provider-solutions.com

 

Billing FAQ’s

Is Internal Medicine of Arizona contracted with my insurance?

Internal Medicine of Arizona is contracted with Aetna PPO, BCBS PPO, Cigna PPO, non-participating with Medicare.  There are countless plans under each insurance so please call your insurance to verify your eligibility  as we do not have an eligibility department.    IMA is not a BANNER, LOCAL Plus, or ALLIANCE provider, if your insurance is affiliated with these networks, they may not cover services.

 Why did I receive a bill?

You may receive a IMA  bill for a variety of reasons. For example:

Please contact your insurance company with any questions on any denied charges or out-of-pocket amounts left for you to pay.

What should I expect as a new patient?

New patients are required to have a full physical, including fasting labs, EKG, chest xray, physical, and exam.   A spirometry and an ICG may also be required depending on age and risk factors.

 My  insurance pays 100% for physicals, why am I receiving a bill?

According to the ACA, insurances are required by law to cover the physical (99384-99387 or 99394-99397); however, each additional service is up to  insurances’ discretion to cover at 100% as preventative or apply to patient’s responsibility.
Please refer to plan booklet and/or  call your insurance for details.

Why does Internal Medicine of Arizona require a physical, EKG, ICG, chest x-ray, and fasting labs once per year?   Is that covered by my insurance?

Although some insurances don’t cover under their preventative benefits, others do.  With that said, our physicians believe the benefits outweigh the risks.  Over the years we have found them to be useful and successful in early detection.  The task forces use multiple criteria to make their decisions on things, not all of which are in the best interest of the individual, but to the population as a whole, taking into account cost as part of their decision making, but we all know that life is our most important currency, and our physicians believe in taking care of our patients in the best possible way.  Below is a link to the Mayo clinic executive program, and as you can see, they recommend/perform this on the patients in this program.

https://www.mayoclinic.org/departments-centers/mayo-clinic-executive-health-program/sections/executive-health-standard-protocol/gnc-20253373

 

Medicare states IMA billed a physical 99397 instead of a wellness, what is the difference?  Why can IMA not bill a wellness visit?

Medicare Annual Wellness Visit vs. an Annual Physical

Medicare will cover an annual wellness visit, but not an annual physical.  “Well,” you might ask “what’s the difference?”  During a Medicare annual wellness visit, the provider will measure height, weight, body mass index (BMI), and blood pressure.  The provider will also go over your medical history, family medical history, and any potential risk factors for preventable diseases such as Type II diabetes and depression.

An annual physical is a more extensive exam than a Medicare Annual Wellness Visit. In addition to these services, a typical annual physical might also include services such as a vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, and a check of your reflexes.  Any blood work or lab tests that may be part of a physical exam, are also not included under a Medicare Annual Wellness Visit.

The purpose of the annual wellness visit under Medicare is to paint a picture of your current state of health and to create a baseline for future care.  Any additional tests or labs that may be required as a result of the findings of your annual wellness visit would be billed separately by your doctor and would fall under a different benefit than your annual wellness visit.  Medicare also covers several other preventive services at no cost such as preventive cancer screenings, bone density measurement, and flu shots.

Internal Medicine of Arizona  is a “non-participating” provider with Medicare, what does that mean?
Non-participating providers accept Medicare but do not agree to take assignment in all cases (they may on a case-by-case basis). This means that while non-participating providers have signed up to accept Medicare insurance, they do not accept Medicare’s approved amount for health care services as full payment.

Non-participating providers can charge up to 15% more than Medicare’s approved amount for the cost of services you receive (known as the limiting charge). This means you are responsible for up to 35% (20% coinsurance + 15% limiting charge) of Medicare’s approved amount for covered services.

If you pay the full cost of your care up front, your provider should still submit a bill to Medicare. Afterward, you should receive from Medicare a Medicare Summary Notice (MSN) and reimbursement for 80% of the Medicare-approved amount.

The limiting charge rules do not apply to durable medical equipment (DME) suppliers. Be sure to learn about the different rules that apply when receiving services from a DME supplier.

 Are Medicare patients required to pay for labs at time of service?

Why did I receive a bill for Vitamin D, 82306?

Most insurance companies will no longer cover vitamin d testing as a routine screening, insurance may make patient responsible for the entire billed amount.   If a patient is deficient insurance will apply a portion to patient responsibility for being a diagnostic test to see vitamin d levels.

Does  Medicare cover Tdap shots 90715 tetanus boosters?

Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) don’t cover the Tdap shot.

Generally, Medicare prescription drug coverage (Part D) covers all commercially available shots needed to prevent illness. Contact your Medicare drug plan for more information about coverage.

Do commercial plans cover Tdap shots 90715 tetanus boosters?

Please contact your insurance directly as each plan may have different benefits for immunizations.

Do  Medicare plans cover Shingles shots?

Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance) doesn’t cover the shingles shot.

Generally, Medicare prescription drug plans (Part D) cover all commercially available vaccines (like the shingles shot) needed to prevent illness. Contact your Medicare drug plan for more information about coverage.

Does Medicare cover Bone Density DEXA screenings?

Bone mass measurements

($45 if Medicare does not consider medically necessary)

Medicare Part B (Medical Insurance)

covers this test once every 24 months (or more often if medically necessary) if you meet one of more of these conditions:

Which “tier” is IMA considered with BCBS PPO?

IMA is considered a tier 2 provider. Please contact BCBS for your plan benefits.

Why did I receive a bill from Sonora Quest?

Sonora Quest billed the wrong insurance

Insurance updates can be submitted through their website on the  update insurance information page. This and other requested information can also be faxed to (480) 565-3962 or mailed to the address on your invoice. Please reference your accession number on any fax or mailed correspondence. You can also call the Customer Service phone number listed on your invoice, or contact our online Customer Service. If the message on your invoice indicates that your insurance carrier needs more information from you in order to process your claim, please contact your insurance carrier directly.

The lab that was preformed could not be run at IMA lab.

Many diagnostic tests can’t be run at IMA internal lab and will be sent out, these labs are diagnostic and not preventative, please contact your insurance or the lab for more information.

Why am I being charged for additional testing which was not on my original test order (requisition)?

There are two reasons that an additional test, which was not originally ordered by your physician, would be performed. The first is that one of the tests your physician ordered may have been a “reflex” test. Reflex testing may result in an additional test being performed depending on the results of the original test. The reflex test is performed to get more detailed information about the findings of the initial test. The second is that your physician may have called the laboratory to request additional testing after the order was submitted, add on testing.

How Medicare works with other insurance

If you have  Medicare and other health insurance (like group health plan, retiree health, or Medicaid coverage), each type of coverage is called a “payer.” When there’s more than one payer, “coordination of benefits” rules decide which one pays first. The “primary payer” pays what it owes on your bills first, and then sends the rest to the “secondary payer” (supplemental payer) to pay. In some rare cases, there may also be a third payer.

What it means to pay primary/secondary 

If the insurance company doesn’t pay the  claim promptly (usually within 120 days), your doctor or other provider may bill Medicare. Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should’ve made.

How Medicare coordinates with other coverage

If you have questions about who pays first, or if your coverage changes, call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627). Tell your doctor and other  health care provider about any changes in your insurance or coverage when you get care.

I received information from my insurance carrier about my benefits and I do not understand all of the information. Can you help me?

For information regarding coverage and benefits from your insurance carrier, please contact your insurance carrier directly. Information about how a specific claim is processed should be provided to you from your insurance carrier on an Explanation of Benefits (EOB) form. These forms usually differ with each insurance carrier. You can visit our explanation of benefits page for a glossary of terms, which may help you interpret the information provided by your insurance carrier.

How can I obtain self-pay patient pricing information (for individuals who do not want to use health insurance coverage to pay for their services)?

Please contact our billing department to obtain a quote of self-pay services.

Can  Internal Medicine of Arizona tell me how much I can expect to pay for my tests?

The price you pay for tests performed by Internal Medicine of Arizona may be dependent on several variables, such as:

I received a pap at IMA, why am I receiving a bill for the specimen from another lab? (Lab Corp/Sonora)

Your doctor will preform the action of a breast exam and pap smear, the specimen is always sent out.  The medical standard is a Pap w HPV, each insurance company has specified coverage determination for these tests, please call your insurance directly.

(i.e. Aetna’s policy on pap/HPV:  http://www.aetna.com/cpb/medical/data/400_499/0443.html)

Patient
Services

General

General

Preventative Care, Physical Examinations, Treatment of minor injuries, short-term illnesses, and more.
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Laboratory

Laboratory

IMA has a CLIA certified, comprehensive reference laboratory onsite for the convenience of our patients.
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Radiology

Radiology

IMA has an onsite Radiology facility with a full time Radiology Technician available during office hours.
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Cardiovascular

Cardiovascular

IMA is equipped with updated cardiovascular diagnostic equipment, including EKGs, ICG testing, and Treadmill Stress Testing.
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Internal Medicine of Arizona contact us (602) 522-1900