Insurance
Health Insurance
Our Billing Specialists will help you with your insurance plans. We will bill all medically necessary services to your primary health insurance plan. We welcome new patients.
Health
- Medicare
- Anthem – Blue Cross PPO
- Blue Shield PPO
- Aetna PPO
Medicare
We accept Medicare. We are a non-assignment Medicare provider. This means our in-house Billing Specialist will promptly submit your claim to Medicare, and Medicare will send you a reimbursement check, typically within just 14 days. You will pay for services when they are rendered. For any questions related to billing or insurance, please contact our office directly and ask for our Billing Specialist.
Nonassignment of Benefits
Under the Medicare program, there are two Medicare reimbursement options. They are Assignment and Nonassignment. This means your physician may choose to not accept assignment of benefits. Under this reimbursement method, the Medicare payment will be made directly to the beneficiary/patient to the address the beneficiary has on file with Medicare.
The provider may bill the patient no more than the limiting charge for covered services. When a provider does not accept assignment on a Medicare claim, he/she is not required to file a claim to the patient’s secondary insurance. However, in Dr. Tokuhara’s office, our in-house Billing Specialist will ensure a claim is filed to the patient’s secondary as a professional courtesy.
An exception to the non-participating agreement is that non-participating providers are required to accept assignment of clinical laboratory services, drugs [such as Eylea], and biologicals. Medicare pays all clinical labs at 100% of the clinical lab fee schedule.
For more information about Medicare non-assignment, please visit the Medicare website directly at: Assignment and Nonassignment of Benefits – JF Part B – Noridian (noridianmedicare.com)
Vision Plans
Although we do not participate in Vision plans, we can help you to submit a claim for your routine vision exams and prescription eyewear.
