Frequently Asked Questions

Do you accept my insurance for physician visits, procedures and surgery?

The only insurance we accept and bill is regular Medicare, and BCBS PPO plans. We are out-of-network for Blue Select. We do not bill Medicare Advantage plans, or any Medicaid plans.

We have made the decision to limit private insurance so that we can provide the highest level of care possible, without the constraints of multiple insurance carriers, and to keep practice resources going to patient care. This model of care is up and coming throughout various specialties and is a great way to value the doctor-patient relationship, and remove the middleman or third party payer.

For those who we do not accept your insurance, we have priced our services to be comparable or less than out-of-pocket expenses at a traditional insurance-based practice, so you get all the benefits of a boutique, personalized practice without paying premium prices. After your appointment, upon request, we can provide you with a superbill that you can submit to your insurance carrier, if you are eligible for out-of-network reimbursement. Most PPO plans have out-of-network benefits. We do not submit out-of-network claims or superbills on your behalf, but can guide you on this relatively simple process and any eligible reimbursement will be paid directly to you from your insurance company. Reimbursement is not guaranteed and is between you and your insurance carrier.

How do I pay for my visit?

The full fee is required at time of service. Cost will always be transparent and communicated before your visit, whether in-network or out-of-network with us.

For IN-NETWORK patients:

The cost of services are as per your insurance plan. We will always do our best to estimate cost, inform & collect your patient responsibility in cost-sharing from you at the time of your visit, but your final statement may reflect copays or amounts that applied to deductible, depending on services actually performed after the claim is paid by insurance. If there are any additional procedures recommended at time of visit, we will advise on a cost estimate prior to performing.

For OUT-OF-NETWORK patients, your options for payment are:

Out-of-network (OON) reimbursement. We will provide you with an itemized receipt of services. The amount reimbursed will vary based on your OON benefits. Most PPO plans have OON benefits. HMOs, Medicaid and Medicare do not. We do not submit out-of-network claims directly to your insurance company for payment to us. Any OON claim you submit, will be paid to you.
Your HSA or FSA (Healthcare Savings Accounts, or Flexible Spending Accounts) is a great option with tax savings.
Care credit – a health care services credit card. We will assist you with this where needed. This is a good option for higher cost services such as procedures or surgery.

How will I pay for laboratory services or other ancillary services done outside of the office?

If you have insurance, it CAN still be used as usual for lab work, and will be sent to your preferred in-network lab for pap smear, lab testing, & pathology, regardless if Dr Reyes’ services are in- or out-of-network.

We offer the convenience of blood draws in the office, and other common lab testing. We will send the tests to your preferred lab such as Quest, Labcorp, or Baycare.

If you are uninsured, we have wholesale-cost labs available in office for you.

How will I pay for pelvic ultrasound or radiology services?

We provide the convenience of in-office ultrasound performed by Dr. Reyes, and this would be an out-of-network expense unless you have BCBSFL PPO plan, or Medicare.

If preferred, we may give you an order for pelvic ultrasound, to go to an outpatient imaging center.

Mammograms are ordered and sent to whichever outpatient imaging center you prefer in the community.

Is my out of pocket expense tax deductible?

Discuss with your tax advisor, but many Americans are eligible for tax deductions for money spent outside of insurance premiums for healthcare expenses. If 7.5% of your annual gross income is met with medical expenses, those are eligible.

What is an HSA and FSA?

HSA

‍Tax-advantaged patient-owned accounts that allow you to save pre-tax dollars for future qualified medical expenses, whether that be expenses towards deductibles, or out-of-network services. These funds generally do not expire.

FSA

‍Tax-advantaged employer-owned accounts that allow contributions of pre-tax dollars for qualified medical expenses as well, but do not always roll over to the following year. Money you save in either an HSA or an FSA, saves an amount equal to the taxes you would have paid on the money you have set aside. Win-win!

‍*Please seek advice from your CPA or tax advisor as this should not be taken as tax advice.

Why did I get a bill after my annual wellness visit covered by insurance?

The Affordable Care Act promotes that the annual wellness exam is "free" if you have insurance. This is true. What they did not tell you, was that an annual wellness visit, when defined & paid by insurance, is strictly a breast and pelvic exam, and a review of preventative health services. Anything outside of this, or any gynecologic problem, is considered a problem visit, and will be billed as an office visit, as per your insurance plan. We are happy to combine your annual wellness and address your problems at one visit, for your convenience, or you may schedule them to be done separately. Letting us know at time of scheduling an annual visit, is best so we may estimate cost for you before your visit to our office. Addressing issues outside of an annual wellness is a common reason you may receive a bill after what you thought was your "free annual" - which is usually a copay or deductible amount. We will do our best to inform you in real-time, but things are not always clear until a claim is paid by insurance. We appreciate your understanding.

If you have any question about a bill, please reach out!

The above does not apply to out-of-network patients who are not utilizing their insurance to pay for services.

What other cost savings are available?

For uninsured patients, or those with high out of pocket costs due to high deductible health plans, we offer wholesale priced common blood lab testing, pap and HPV testing, STI testing, urine testing, and pathology testing. Inquire directly for pricing, or you will be advised on cost of these tests recommended by the doctor, the day of your visit.