Contracted Health Plans
Flexible Options for Every Patient
At Pacific Palisades Medical Group, we believe access to quality care should be simple. That’s why we provide multiple options:
Contracted PPO Plans
We are contracted providers with:
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UC Care (only) Blue Cross
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Blue Shield of California
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Blue Cross/Blue Shield affiliated plans in California
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Medicare
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United Health Care
For these plans, our office will submit claims and accept contracted rates (patient responsible only for deductibles and co-pays).
Direct Contract Primary Care Option
An option for those who have no insurance or are members of a non-contracted PPO Plan.
Included Services
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Annual wellness exams & physicals
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Well-woman & well-child visits
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Urgent care visits for common conditions
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Follow-up care for chronic medical issues
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In-office diagnostic tests (EKGs, labs)
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Annual flu vaccination
Excluded Services
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Immunizations and vaccinations other than annual influenza vaccination
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Medical devices or supplies
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Long-term psychiatric counseling beyond brief episodic or routine primary care counseling
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Out of office labwork
Advantages
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No insurance hassles for primary care services
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Fixed annual fee for primary care services with no hidden costs, deductibles or co-pays
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Cuts out the problematic insurance “middleman” between you and your primary care physician
Non-Contracted PPOs
For patients who have Preferred Provider Insurance Organizations (PPO) insurances that are not contracted with the PPMG, payment for services rendered is due at the time of service. The PPMG will send an initial claim form to your insurance company for all physician services, as a courtesy to you. Any balances owed will be billed at the end of each monthly billing cycle.
HMO Plans
PPMG is not contracted with any Health Maintenance Organization (HMO) type of healthplan. HMO covered patients who wish to see PPMG physicians will be billed as cash patients or can take advantage of our Direct Contracting option as a convenient way to receive their primary care needs from this office.
Laboratory, Radiology and Other Diagnostic Tests
Non-office based laboratory tests, radiological services and most other ancillary services are separately billed by the source of the service, usually UCLA Healthcare, Quest, Tower Imaging or Providence/St. John's. These entities are contracted with most all health plans. You will receive separate statements and bills for these services that are not part of your fiscal relationship with the PPMG.
