Pulmonary Associates of Richmond participates with most insurance plans. However, listed below are the insurances we DO NOT ACCEPT:
What is a referral?
A referral is an authorization from the patient’s Primary Care Physician (PCP) for the patient to see a specialist. A PCP is a Family Doctor or Internist. Some insurance companies require you to have a referral to see a specialist. If your insurance company does not require a referral, you do not have to see your PCP before scheduling an appointment with one of our doctors.
How do I know if I need a referral?
You only need a referral if your insurance company requires you to have one.
The best way to know for sure is to contact your insurance company. The phone number is on your insurance card.
Some insurance cards state on the card whether or not you need a referral. If you are not sure, contact your insurance company before your appointment.
How do I get a referral?
You need to contact your PCP and tell them that you need a referral for your visit.
How does my referral get from my PCP to the specialists?
You can have your PCP fax the referral to the office, but the best way to be sure that we get it is to pick it up from your PCP’s office and bring it with you to your appointment. That way you eliminate the chance of it not being here when you arrive.
What happens if I don’t have a referral the day of my appointment?
Unfortunately, if your insurance company requires a referral and you don’t have one, they will not pay the claim for your visit and you will be responsible for the bill. This is why we can not see a patient without a referral.
Do I have to get a referral every time that I see a specialist?
Each referral has an expiration date. If you need to come back to a specialist after the expiration date has past, you need another referral from your PCP. Also, some referrals have a limited number of visits allowed. For example the referral may be good for 1 year, but only allows 3 visits; therefore, if you need to see the specialists a 4th time, you will need another referral from your PCP.
Why do I have two copays for my sleep study?
When you have a sleep study your insurance requires you to pay a copay for the study. The next morning the physician or physician extender will see you and review the study results with you unless you choose not to stay for this visit. Since this is a second day, some insurance companies consider this a second visit and require you to pay a second copay.
What should I bring to my appointment?
Please bring a current list of your medications, your insurance card, and your copay. We will also need your medical records and any recent (last 3 month) chest x-rays or chest CT scans. If you are being seen in the sleep lab and have a CPAP machine, please bring your machine with you.
Do all the doctors work at the same location?
No, we have four locations and our doctors all work at one office location and one or two hospitals regularly. Our doctors work in teams to cover the hospitals and the offices, so you may see one of your doctor’s partners if you are in the hospital.
Why isn’t my doctor in the office every week?
PAR doctors are Pulmonary and Critical Care physicians. This means that they specialize in the treatment of lung disorders and patients that are critically ill. Our doctors work in teams to make sure that they are available to patients in the hospital and in the office each week. Your doctor may work two weeks in the hospital and one week in the office. But don’t worry, if you need to be seen in the office while your doctor is working in the hospital, you can see one of our Physician Assistants, Nurse Practitioners, or another physician.
Why do I have to come in for a consultation appointment before having a sleep study?
Some patients need to have a sleep study done in our sleep lab; however, some patients can have a home sleep study. In order to determine which kind of study is right for you, it is necessary for one of our sleep specialists to see you in the office. This also gives us a chance to give you a tour of the lab and explain how the study will work. We have found that patients are much less apprehensive about the study once they have had a tour and met the staff.
How much is my sleep study going to cost me?
Unfortunately, every insurance plan is different, so it is hard for us to say how much you will owe. The best thing you can do to estimate this cost is to talk to your insurance company. Before you call your insurance company, talk to our billing office so that you can get the CPT code for the test. You can reach the billing office at 804-320-4243.
To whom do I make my check payable when I pay a bill?
Make your payment to PAR or Pulmonary Associates of Richmond.