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Billing & Reimbursement

The USC Center for Vascular Care believes that high quality health care should be accessible to everyone. As a result, we have contracts with more than 100 insurance plans including private insurance, HMOs, Medicare and Workers Compensation. These include:

PPO/POS/EPO

  • Admar Corporation
  • Affiliated Health Funds
  • Airconditioning & Refrigeration
  • AHC
  • BCE Emergis
  • Beech Street PPO
  • Benefit Panel Service (BPS)
  • Best Doctors, Inc
  • Blue Cross Prudent Buyer
  • Blue Shield of California PPO
  • California Foundation for Medical Care
  • CCN PPO
  • CIGNA PPO
  • First Health PPO
  • Focus Healthcare Management PPO
  • Health Plans of Nevada
  • HealthNet PPO
  • Medical Network Incorporated (MNI)
  • MultiPlan
  • One Health Plan
  • Pacific Health Alliance PPO
  • PacificCare PPO
  • PPO Next
  • Preferred Plan
  • Private Health Care Systems (PHCS)
  • ProAmerica
  • Sheet Metal Workers Trust Fund
  • Southern Cal Pipe Trades Fund
  • Tertiary Care Network
  • Union Roofers Health & Welfare
  • United Healthcare
  • United Payors & United Providers
  • Universal Care
  • USA Managed Care Organization
  • USC Network
  • Value Options

HMO

  • Access Medical Group
  • Affiliated Doctors of Orange County
  • Alliance Medical Group
  • Alliance Physicians Services
  • Allied Physicians of California
  • AV Medical Group
  • Bakersfield Family Medical Center
  • Bright Medical Associates
  • California Desert Medical IPA
  • Caremore Medical Group
  • Cedars Sinai Health Associates
  • Cedars Sinai Medical Group
  • Chino Medical Group
  • Desert Valley Medical Group
  • Doctors Medical Group of West Covina
  • Downey Select IPA
  • Eastland Medical Group
  • Edinger Medical Group
  • Gateway Medical Group
  • Glendale Physicians Alliance
  • Global Care Medical Group
  • Good Samaritan Medical Practice
  • Greater Covina Medical Group
  • Greater Valley Medical Group
  • Hanson Medical Group
  • Healthcare LA IPA
  • HealthCare Partners
  • Heritage Provider Network
  • Heritage Victor Valley
  • High Desert Medical Group
  • HPPN-Arcadia
  • HPPN-Pasadena
  • Kaiser Permanente
  • Lakewood Health Plan
  • Magan Medical Group
  • Molina Medical Centers
  • Monarch Healthcare
  • Northwest Orange County Medical Group
  • Physician Associates
  • Pioneer Medical Group
  • St. Joseph Heritage Healthcare
  • St. Mary’s Choice Medical Group
  • St. Vincent IPA Medical Group
  • Total Medical Care
  • Unified Physicians of the South Bay
  • West Covina Medical Group

* Please note this is not a complete listing and contracting is subject to change. Please call (323) 442-5988 for questions.

Cash payment plans are also available and can be negotiated with our physician offices.

As with all aspects of your healthcare, it is important for you to learn and know the specific of your insurance plan. Some suggested questions to ask your carrier are:

  • Is this a Point of Service agreement (“POS”), Preferred Provider Organization (“PPO”) or Healthcare Maintenance Organization (“HMO”)?
  • Will I need an authorization for specialty services?
  • Do I need additional authorization if surgery is required?
  • What is my co-payment responsibility?
  • Have there been any changes to my co-payment responsibility?
  • What is my deductible?
  • Has my deductible been met?
  • What if I go out of plan?
  • Have my benefits been assigned?

In addition, please note adherence to the following:

  • If authorization is required and not received at the time of visit, your appointment will need to be rescheduled.
  • If arrangements have been made for a cash pay consultation, payment is due at time of visit.
  • Co-payments are due at the time of your visit.
  • A copy of your driver’s license and insurance card will be requested at each visit. This is for your protection as well as ours.
  • It is important to let us know if your insurance has changed since your last visit or surgery.
  • All major credit cards and credit/debit cards are accepted.

Our vascular billing and reimbursement specialists are very experienced and well trained. For questions regarding your claim please contact:

Judith Gonzales at (323) 442-5767 for patients of Dr. Douglas Hood, Dr. Steven Katz, Dr. Roy Kohl and Dr. Vincent Rowe or, Rebecca Barber at (818) 790-7332 for patients of Dr. Fred Weaver and all vascular laboratory studies.

If you are a Health Plan or Managed Care Provider who would like more information about contracts with the USC Center for Vascular Care, contact us at (323) 442-5734

Health Insurance Glossary of Terms

Co-insurance: The amount you are required to pay for medical care in a fee-for-service or PPO plan after you have met your deductible. The coinsurance rate is usually expressed as a percentage. For example, if the insurance company pays 80 percent of the claim, you pay 20 percent.

Coordination of Benefits: A system to eliminate duplication of benefits when you are covered under more than one group plan. Benefits under the two plans usually are limited to no more than 100 percent of the claim.

Co-payment: Another way of sharing medical costs. You pay a flat fee every time you receive a medical service (for example, $5 for every visit to the doctor). The insurance company pays the rest, excepting any deductible or co-insurance due.

Covered Expenses: Most insurance plans, whether they are fee-for-service, HMOs, or PPOs, do not pay for all services. Some may not pay for prescription drugs. Others may not pay for mental health care. Covered services are those medical procedures the insurer agrees to pay for. They are listed in the policy.

Deductible: The amount of money you must pay each year to cover your medical care expenses before your insurance policy starts paying.

Exclusions: Specific conditions or circumstances for which the policy will not provide benefits.

HMO (Health Maintenance Organization): Prepaid health plans. You pay a monthly premium and the HMO covers your doctors' visits, hospital stays, emergency care, surgery, checkups, lab tests, x-rays, and therapy. You must use the doctors and hospitals designated by the HMO and must receive an authorization for specialty services referred by your primary care physician.

PPO (Preferred Provider Organization): A combination of traditional fee-for-service and an HMO. When you use the doctors and hospitals that are part of the PPO, you can have a larger part of your medical bills covered. You can use other doctors, but at a higher cost.

Premium: The amount you or your employer pays in exchange for insurance coverage.

Primary Care Physician (“PCP”): Usually your first contact for health care. This is often a family physician or internist, but some women use their gynecologist. A primary care doctor monitors your health and diagnoses and treats minor health problems, and refers you to specialists if another level of care is needed.

Provider: Any person (doctor, nurse, dentist) or institution (hospital or clinic) that provides medical care.

Third-Party Payer: Any payer for health care services other than you. This can be an insurance company, an HMO, a PPO, or the Federal Government.

 

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USC Vascular Surgery
1520 San Pablo St.
Suite 4300
Los Angeles, CA 90033-5330

E-mail: vascular@med.usc.edu
Phone: (323) 865-1544

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Copyright © Vascular Surgery
University of Southern California Department of Surgery
Keck School of Medicine of USC
1520 San Pablo St., Suite 4300, Los Angeles, CA 90033-5330
Email: vascular@med.usc.edu
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