Your Insurance in Our Office

Dr. Hitesh Patel is not a participating provider with any medical insurance company and is considered as an "out of network" provider. Dr. Patel treats his patients at what he believes to be the highest level of care and does not compromise standard of care based on insurance codes and benefits. You will be asked to pay for services at the time of your appointment and/or treatment. As a courtesy, Dr Patel has hired an outside billing company, if you have a PPO plan they are happy to file any necessary insurance forms, check verification of benefits before consultation and assist in the processing of claims after your initial consultation or after start of treatment with us. We cannot file to HMO, Medicaid or Medicare plans. Medicare patients will be required to sign an "opt out" agreement and will not receive reimbursement from Medicare since Medicare does not pay for appliance therapy. Help for filing of insurance is done as a courtesy, and since we are not participating providers of any plans, we cannot guarantee what type of reimbursements you will receive or what will be covered. Many of our clients sign up for Care Credit, so they can begin the work of reducing their pain at a more affordable monthly payment. Our office offers 0% financing for 12 months with Care Credit. 

Other payment forms accepted: Cash, Check Visa, Mastercard, American Express, Discover, HSA or FSA Cards.

0% Financing available through Care Credit

Frequently Asked Questions

What is an In-Network Participating Provider?

The healthcare professional has a contract with your insurance company agreeing to a dollar amount for a service and adjusts the fee based on the contract amount.

What is an out-of-network or non-contracted provider?

The healthcare professional does not have a contract for services with the insurance company. There may be benefits available; however, the benefit is not determined until the claim is reviewed. Therefore, the insurance company is not able to provide the dollar amount for a service to an out-of-network provider.

What is an HMO vs PPO?

With an HMO you have benefits available only when you receive services from an in-network or contracted provider. PPO plans allow benefits for both in and out-of-network providers. Occasionally, if receiving a service from an out-of-network provider or facility, the benefit may be reduced, but there is still some dollar amount. 

What is a deductible?

The dollar amount that must be satisfied prior to the insurance plan making any payment reimbursement.

What is co-insurance?

The percentage the member is responsible for covering after the deductible is met. 

What are "Reasonable and customary limits or allowed amounts for services?

The arbitrary amount an insurance company sets as the fee for a particular product, procedure, or service. For example we will bill the insurance the full fee for each service, but your benefit coverage or payment will be based on the dollar amount they have chosen. 

What are exclusions or limitations?

There are times where an insurance plan or group will not provide any payment or allow any benefit for a particular diagnosis or service. Limitations are occasionally seen as the maximum amount an insurance company will allow or pay for a particular diagnosis or service. The limit can be either in the form of a dollar amount or a percentage. 

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