ANNUAL PHYSICAL

NOTICE TO PATIENTS REGARDING ANNUAL PHYSICAL EXAM:

You have scheduled an annual exam for today. Your insurance company may call this visit "preventative", "yearly" or "annual. Please take a moment to read the remainder of this letter. Due to national coding laws, we must bill your insurance company for your exam today as a preventative care visit. If, during your visit, you have additional concerns or conditions that require diagnosis and treatment, you may incur additional office or lab charges. These charges will be submitted to your insurance company as well as the preventative visit. If your insurance company does not cover some or all of the charges, you will be billed for the balance your Insurance indicates patient responsibility. Please do not ask us to re-bill by changing a procedure or diagnostic code. By asking this of your provider, you are asking him to commit insurance fraud.

Please be aware of your insurance coverage and benefits. It is your obligation to know your policy's benefits and limitation, as they are a private contract between you, your employer and your insurance company of which your physician is not involved. Contact your insurance carrier prior to your visit as to whether this is a benefit under your policy. If preventative care coverage is not part of your insurance benefits, we may ask for payment at the time of service.

Please be aware that the Initial Physical Examination (IPPE) also known as the "Welcome to Medicare" visit is not the "routine physical check-up" that some seniors may receive every year or two from their providers. Medicare DOES NOT provide coverage for routine physical exams. Am IPPE consists of a history, medication review, fall risk screening, depression screening and vital signs. An EKG may be done and will be billed separately. Coverage of the IPPE visit is provided as a Medicare Part B benefit. The Medicare deductible is waived for the IPPЕ. А patient may have one IPPE exam in a lifetime, and it must be done within a year of becoming eligible for Medicare. If you are here for the "Welcome to Medicare" IPPE, please be sure to tell the Front Desk and your provider.

If you have any questions that your insurance carrier cannot answer, please do not hesitate to contact our business office at (323)765-1500, Monday through Friday. Thank you for your understanding in this matter, your cooperation is greatly appreciated.