A long-term relationship with a Paseo care provider allows us to help keep you moving toward a long, healthy life. Among the wellness and prevention offerings we provide are: To maintain good health, adults are encouraged to obtain regular check-ups, screenings and immunizations. Links to guidelines for routine care are provided below: Understanding Preventive Services and Insurance Billing

Insurance policies vary dramatically and it is virtually impossible for us to know the benefits for each patient.Therefore, the following was created to assist you in understanding your benefits:

What are Preventive Services?

Also referred to as a screening, check-up, physical and/or a get established visit, preventive services are designed for patients who are not experiencing any symptoms, chronic health issues or preexisting conditions.

Are they covered?

Each plan has clearly defined parameters for which, if any, preventive services are covered. Testing such as ECG, lab work, DXA, vaccines, for example,may or may not be included in your annual check-up or physical. In most instances,we try to verify your medical benefits with your insurance company prior to your visit.However, verification of your benefits is not a guarantee of payment.That's why you may receive an additional bill for service. We encourage you to review your policy or call the number on the back of your insurance card to determine the extent of your coverage.We think it is important for you to understand what you will be responsible for paying prior to receiving services.

What happens if we address a specific health issue at a preventive visit?

Testing and additional services used to evaluate specific symptoms or to manage an existing disease are not considered preventive. Insurance companies require us to use a list of codes representing each of the services we perform as well as codes for your particular diagnosis or reason for your visit. Should you come for a physical, for example, and also ask your provider to evaluate a respiratory illness, our billing would reflect charges for both the physical and the respiratory illness. If you only want a physical or preventive service done during your visit, please be sure to inform your provider prior to services being rendered.At that time, your provider can explain to you his/her recommended course of treatment.

Can I request a change in my insurance billing?

No.Our billing must reflect what actually happened during your medical visit and match what is recorded in your medical record. Appropriate billing is a federal legal requirement. It is considered fraudulent to change billing information solely to obtain reimbursement.

Will all services received during my visit be billed through Paseo Primary Care Physicians?

Most services are billed through our office including medical visits and exams, on-site surgery (removal of skin lesions, etc.), injections, quick strep tests and urinalysis and supplies. For your convenience, Sonora Quest is on site for all other lab testing including blood draws and PAP smear evaluation. Patients are billed directly from Sonora Quest for those services.Any questions regarding lab bills should be addressed directly to Sonora Quest.
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