Insurance & Rates

BEFORE YOU GO ANY FURTHER PLEASE READ THIS ENTIRE SECTION!

It is the patient's responsibility to understand his/her own health plan, and to verify with their insurance company that an office visit to Dr. Gutierrez and our other providers are covered. The patient will be fully responsible for charges that insurance does not cover, as per our financial policy.

For this reason, we require that all patients send us their insurance information a minimum of 24 business hours before their scheduled appointment. If we do not receive the following information below, before the 24 business hours, we will cancel your appointment to allow room for our emergency appointments to schedule.

Insurance info needed:

1. Insurance Company

2. Insurance ID Number

3. Insurance Group #

4. Are you the Policy Holder?
   (If this is for a minor, please know we only see ages 14 and up, thank you.)

5. Do you have any secondary insurance?
   (*Please inform us if you have a secondary insurance, even if it is not on our accepted list as they may have special rules)

What if I have coins instead of a copay, or deductibles to meet?

Insurance will not show us what your total coinsurance will be until we submit a claim to them, for this reason it is our company policy to collect a flat rate at time of service for plans with any coinsurance, which will be reconciled (billed/refunded) once the statement from the insurance company specifies the exact dollar amount.

It is also our company policy to collect the cash price of your treatment up to the amount of your deductible for any unmet deductible. Both of these company policies help our clients budget for known expenses and avoid large unwanted bills months after the treatment.

How can I send you my insurance information?

For your privacy and security we ask that all patient communication be through your Athena Patient Portal when you sign up and schedule or by giving us a call at 458-205-5907.

How to upload my information through the portal?

You can enter this information when you sign up however, you can see our FAQ tab

What Insurances do you accept?

We are in-network and currently accepting new patients with the following PPO policies:

• Blue Cross and Blue Shield/ Bridgespan: Participating, Preferred, Individual & Family, RealValue only  includes the entire BCBS family: Regence, Anthem, etc.

• PacificSource (not OHP Community Solutions)

• Providence (Signature Network, not a PCP for Choice)

• Aetna (including Meritain and GEHA)

• United / UMR

• HMA

• Moda (Connexus and Affinity Networks only

• Cigna

What if I have Medicare?

We do see Medicare patients however, we are NOT accepting new patients with original Medicare, MedAdvantage or Medigap plans.  
Also, we are not accepting new patients with Medicare as their secondary insurance.

If you were a previous patient of one of Wendy on Medicare, you can call to be added to her Medicare waitlist as she has limited spots available. This does not guarantee a new patient appointment with her, this means that when she has an opening in one of her Medicare spots we will reach out to you in the order that you are on her list.

What insurance plans do you NOT accept?

We are not "in plan" for health plans that require a "medical home," nor do we participate with HMO plans, Trillium, OHP, or any form of Medicaid.  We cannot accept patients with Medicaid as primary or secondary insurance.  It is against our Medicare contract to accept cash payments from patients who qualify for state or federal medical assistance programs, so we cannot treat you even if you are willing to pay cash.

Please read your insurance card.  If your card says, "HMO" or "medical home", we are not covered by your plan even though we may be "in network" for that insurance company.  If your card says "PCP required", please call your insurance company to designate Dr Gutierrez as your PCP BEFORE your visit.  We are not accepting patients with OMIP plans.

What if I have Medicaid/OHP?

We do not have assignments from Medicaid/OHP.  Due to contract restrictions, we cannot see these patients on a self-pay basis nor bill patients for whom OHP/Medicaid is secondary insurance.

What if  I don’t have Insurance?

IF YOU HAVE READ THIS ENTIRE PAGE AND HAVE THE INSURANCE INFORMATION YOU NEED TO SCHEDULE, you can click the link below to schedule.

If you do NOT have insurance, please call 458-205-5907 and we will provide cash pricing info.