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FAQs / Are You “In-Network” with My Insurance Plan?

QUESTION:

Dr. Richardson:

Thank-you for this information. I am a resident of Northern California (Mendocino County). I will soon have a new Covered California Silver 87 plan that will provide much better coverage. The plan is through Anthem Blue Cross. I am currently visiting my mother on an extended stay in SW Florida, but will be returning to the west coast in late April or early May, and can route myself through SOCAL on my return trip. Are you “in network” for my plan?

Attached is a letter of referral from my local ophthalmologist.

******, Ph.D.
Fort Bragg, CA


ANSWER:

Dear ******,

I’ve reviewed the note you forwarded from Dr. ******. I can’t be 100% certain that you are a candidate for Canaloplasty without examining what is called “the angle” at the slit lamp (microscope). That being said, it does appear that you would be a candidate for this surgery. If you are considering Canaloplasty then I would avoid ALT as it can make Canaloplasty more challenging to complete. Selective laser trabeculoplasty (SLT), on the other hand, would not be expected to interfere with Canaloplasty.

I am out-of-network for all insurances. Some insurances, however, may reimburse you for a significant portion of my fees. I’ve copied my billing specialist, Helah, on this email. If you forward your new insurance information she can do some research and may be able to tell you what reimbursement you might expect from your insurance.

I’ve also copied my nurse, Ana, on this email so that she may create a record and upload ******’s note in anticipation of a possible future consultation with me. Please let me or my staff know if there is anything else with which we may be of assistance.

Warm regards,
David Richardson, MD

Date: Tue, Feb 10, 2015 at 2:16 PM

 

Posted in: Canaloplasty, Canaloplasty Cost

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