Insurance Information - Irving W. Olender, M.D. - Gynecology Medical Care in Los Gatos, CA


	Gynecology 15195 National Ave, Suite 201 Los Gatos, CA 95032	Phone 408.358.2788 Fax 408.356.5526

Insurance Information
In recent years the Bay Area has experienced a major upheaval in insurance re-imbursement; and, as a result, many physicians in private practice have terminated their relationship with several major insurance providers. This has left patients in our community anxious and concerned about health care costs. Thus, I think it is imperative that you know where I stand in this matter.
I am a contracted preferred physician provider for nearly all PPO (Preferred Provider Organization) insurance plans. I accept, as payment in full, the amount specified by your insurance carrier for my professional services. You may have to meet a deductible amount first, and there is often a co-payment due at the time service is rendered. You will receive an EOB (Explanation Of Benefits) from your insurance company defining their payment commitment for my services and their determination of your financial responsibility.
There are literally hundreds of specific contracts in force. I cannot list every one I accept. Before visiting my office, it would be wise for you to contact your insurance provider and clarify their relationship with me. You can often find the most current information on your insurance company's internet web site.
My current contracts include (These are all PPO unless otherwise listed):

Admar Aetna U. S. Healthcare

CCN Retail Clerks

Foundation for Medical Care Blue Cross

First Health Blue Shield

Great West Foundation Health-Plan

Interplan HealthNet

Medicare United Health Care

Multiplan Pacificare

PHCS Principle Mutual

Tricare Prime PPO Next

Cigna Guardian Life

I am no longer associated with the Santa Clara County Individual Physician Association. (SCCIPA) which administers many of the HMO (Health Maintenance Organization) plans in service in this county. Thus, I am not able to bill them for medical care I provide you. You will be expected to self-pay for these services if your insurance is an HMO. SCCIPA is also contracted to manage many EPO (Exclusive Provider Organization) and POS (Point Of Service) insurance plans. Similarly, they will only reimburse me if you are entitled to coverage for out-of-network medical services. In these instances, you may have a larger deductible or a co-insurance payment. Please check your insurance policy or insurance card to determine who administers your plan.
You are encouraged to speak to my office staff regarding any questions you might have regarding insurance coverage or any billing issues. My bookkeeper and accounts manager, Corinna Valencia, can be reached at (408) 356-9465. Call her first with your concerns and questions. Please be complete and include and much information as possible. She will research the problem and return your call within 24 hours.
We have found it best to clarify this most complicated aspect of modern health care before your initial visit. It is much more pleasant to deal with health care knowing that your insurance questions have been answered to your satisfaction.