Billing and Insurance

Due to the unique nature of our practice and the time and attention we give our patients, we have chosen not to participate or contract with any insurance companies. We are an "out of network provider." What does an "out of network provider" mean for a patient? Your insurance company will reimburse your office visits and services at a different rate or fee schedule than participating providers. You, the patient, will be responsible for any difference between our charges and the insurance company's approved rate of payment. Steinmetz Medical Associates will, however, assist you in submitting a claim to your insurance carrier.

Our goal is to help you maximize your insurance benefits and minimize any billing and insurance issues. We have designed a billing process that makes it easy for you to use your insurance benefits and clarifies some of the common concerns about billing and insurance.

If you have:

Commercial Insurance (non Blue Cross / CareFirst / Anthem):

• You have an office visit.
• We submit an electronic claim to your insurance company.
• Insurance company pays us and sends us an explanation of benefits (EOB) statement.
• You will also receive an explanation of benefits (EOB) statement.
• After 30 days we bill you for any remaining balance on your account.
• Carriers generally allow 70%-100% of charges.

Blue Cross / CareFirst / Anthem:

• You have an office visit.
• You pay our fees at the time of service.
• We submit an electronic claim to Blue Cross / CareFirst / Anthem.
• Blue Cross / CareFirst / Anthem sends you a check and an explanation of benefits (EOB).
• Carrier generally allows 50% of charges.

Medicare
We have opted out of Medicare, which means that you cannot file a claim with Medicare. However patients can file an insurance claim with their secondary carrier. Medicare patients pay at the time of service for their office visit. Most labs are covered by Medicare. Patients referred out for radiological and specialty services are covered under Medicare.

Medicaid
We do not participate in Medicaid.

Tricare
We do not participate with Tricare. Patients pay at the time of service for their office visits and labs.

See Frequently Asked Questions for Insurance/Billing FAQs