While many of the payers we contracted with will stay the same, some new ones have been added. Follow the link here to see what insurances we are accepting.
Your copay is an agreed upon contracted rate between you and your health insurance company. That will not change with our partnership with Privia/Health First. Should you have a deductible or coinsurance, the amount for the office visit may change.
We accept cash, Visa, Mastercard, Discover, American Express, HSA, HRA, and personal checks.
We encourage patients to keep a credit card on file to make the checkout process easier, faster, and more efficient. It will also reduce statements being sent to you. You will continue to receive your Explanation of Benefits (EOB) from your insurance carrier once your claim has been processed, which details the billed amount, allowed amount per your insurance plan, how much your insurance covers of the allowed amount, and how much you are charged.
At check-in we will scan the credit card of your choice, including your Flexible Spending Account (FSA) or Health Savings Account (HSA) card.
If there is a balance for your medical visit after your insurance has paid their portion, your card on file will be charged the balance owed up to a maximum amount approved by you, and an email or portal receipt will be sent to you.
Your credit card information will always be fully protected by our off-site, card-processing partner Elavon, and not on our computers, as required by industry standards (Payment Card Industry Data Security Standard – PCI-DSS).
Privia is a national physician-focused organization that provides innovative tools and resources to medical practices. They did not buy PremierMED and we continue to remain an independent practice.
Your medical record has gone from a paper chart to an electronic chart. Your physician is now able to view your entire medical history via a computer system called an electronic health record (EHR) or electronic medical record (EMR). The EHR is organized in a way that permits your physician or medical provider to easily see various aspects of your medical history in an organized manner. It also provides a portal for you to access your medical history and connect with the practice. We will be using the EMR system called AthenaHealth.
The old patient portal we used through NextGEN will be closing. You will get an email invitation to our new portal through MyPrivia/Athena Health. You can also begin to access the new portal through this link: https://80421.portal.athenahealth.com/?section=landing&sub=registration_wizard
Billing statements will appear in a new format and include both PremierMED and Privia/Health First Medical Group. We have partnered with Privia/Health First to enhance our medical contracts and to help more people by getting onto insurance plans we didn’t have the ability to join before. Should you have any further billing questions, please email them to Billing@PremierFSM.com. We have found that billing concerns may require more attention, so we will have a dedicated email just for billing questions. You will be able to attach any Explanation of Benefits or invoices for us to review. We will also hire staff dedicated to helping you with billing concerns.
The provider messaging platform within your Privia Patient Portal is a separate application from the technology, called AthenaHealth, that enables your provider to receive and respond to your message. In order to enable secure messaging with your provider, we require third party cookies.
To protect your privacy, your username and password is not shared between these systems.
The major benefit of the EHR for patients is the access our Community Care physicians and non-physician providers have in understanding the various aspects of your medical care. The EHR gives your provider access to your files when they are out of the office, so the doctor can provide care with the most current information when it is needed.
All prescriptions are completed electronically as well. Your doctor can print and sign or fax them directly to the pharmacy from the computer. Once the prescription is in the system, it is easy to renew. This system provides better documentation in prescribing medications.
Yes. An electronic health record is more secure than an ordinary paper chart. Confidentiality is vital in healthcare and is upheld with the computerized system. The system is HIPAA-compliant and requires a password and log-in for each user. There are multiple layers of security- not everyone can access all aspects of a patient’s record. There is a system that tracks who is accessing specific parts of a medical record. Automatic log-offs ensure records aren’t accidentally left open for someone to breach.
No. The computer doesn’t tell the doctor what to do; it simply makes accurate information accessible so the doctor can make the medical decision.
Prescriptions work on our bodies to treat conditions, but our bodies also need to be monitored to make sure the medication is working and also not causing side effects. If your pharmacy sent a refill request or you called for a refill and it was rejected, it is likely that you need or possibly missed a scheduled follow-up visit. Some medications require blood work for routine monitoring, and if it’s been a long time since you had labs done on certain medications, we can’t refill them due to the risk. We also cannot refill controlled substances after a certain time has passed since your last visit. We will outline the expectations for follow-up appointments when a medication is prescribed. Please see below for some examples of conditions that require follow-up visits:
- Controlled substances – every 3 months.
- Blood pressure/cholesterol/depression meds/thyroid/diabetes – a visit every 3-6 months with labs. The frequency of your visits is determined by your provider.
- Testosterone/PrEP – visit and lab every 3 months
You can get a short-term medication refill (7-30 days) but you will be expected to make your regular follow-up visit and labs that day may be required of you.
The turnaround time for testing depends on the time you had your test and the type of test done. We have to wait for the lab to process the blood and send us the results or the radiologist to read the images and send us the report. These are not normally done on the same day you have the blood drawn or imaging test done. For routine imaging and labs, we expect around 7 days for the office to receive the results. All imaging is reviewed by a provider and you may be called with the results or scheduled to follow up and review them. Please note, on STAT imaging or if immediate attention is required, the imaging facility will typically call the provider on the same day and we will notify you.
The initial medical visit is to allow the provider to create a care plan with you, and to go over all your health history (allergies, medications, medical problems, family medical history, prior labs, etc.), and address any immediate medical needs. This may include medication refills, referrals or acute conditions that need to be managed first. There are instances where the first visit may be converted to a physical. This is at the discretion of the provider and only during the establishment visit, after the provider has determined that no immediate needs need to be addressed.
A physical as we understand it, is really referred to as an annual wellness visit by insurances. Most (not all) insurances cover the cost of this visit. At the annual wellness visit the provider will go over your health maintenance for the past year and review preventative health measures specific to you. They will make sure you are up to date with your immunizations, and screening exams, and review or order your annual labs. You are only permitted one “physical exam/annual wellness visit” in a calendar year. Per insurance, the annual wellness visit is not a problem visit. All medical problems, changes in medications or new medications needed, referrals or abnormal lab results needing management that are done during this appointment will be subject to your deductible or co-insurance depending on your insurance plan.
Not all labs and imaging require a follow up, it is condition dependent and is on a case by case basis. We strive to review labs and imaging in a timely manner in order to avoid unnecessary visits. However, if you have abnormal labs or imaging, we have a responsibility as your care provider to educate you on your condition and discuss the plan. Additionally, if the labs were from a physical (preventative visit), you will still be subject to your regular office fee for follow up as lab reviews are not considered “preventative.”
If you have an HMO, you must get an authorization generated by our office through your insurance company to direct you to specialists in your network. If you have a PPO, you typically do not need a referral. However, some specialists require an order from your provider, which will necessitate an office visit to ensure proper documentation is completed.
Although physicals/annual wellness visits are considered preventative and covered 100% by most insurances, labs are not always covered at 100%. Therefore, if you have a deductible or had a test that insurance does not cover, you will be billed for the amount not covered. It is your responsibility to find out what your insurance will and will not cover prior to getting the blood drawn. We cannot provide that information as the plans change on a regular basis and it would not be possible to give an accurate estimate.
Alternative: If you have a high deductible plan, consider opting for self-pay labs instead of going through your insurance. The fee schedule can be provided for you.
New pricing on private pay visits is $147 for a New Patient & $114 for a Follow-up Visit.