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HMO Insurance Answers
Temescal Creek Medicine contracts with HMO plans through Affinity Medical Group for commercial and medicare advantage plans.
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NOTE: Please call us at 510 230-2372 or email tcmadmin@tcreekmed.com to confirm whether we are currently accepting new HMO patients
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Who do I sign up with? You may sign up with either Michael Zimmerman, MD or Lauren Pallis, MD. As long as one of our providers is on your insurance card you may be seen by either.
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Does my HMO plan cover everything? HMO insurance covers office visits and some procedures. You are responsible for your copayments and any charges not covered under your policy.
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Aren't HMOs bad? What is an HMO anyway? Managed Care or HMO (Health Maintenance Organization) model insurance has received a bad reputation over the years. Some of this is deserved, some is not. The idea behind managed care is to have organized networks of healthcare providers take on real responsibility and accountability for the quality, cost and experience of the care they deliver. The HMO concept is great but unfortunately the first versions of this model were all about managing cost not managing care. The newest iterations of this model are Accountable Care Organizations that do continue to attempt to control costs but do so by focusing on quality and patient satisfaction. The managed care model is distinct from PPO or “fee for service” model in which providers only get paid for doing MORE, with limited if any control on cost or quality. While it is the American Way to want more, we have piles and piles of data demonstrating that more tests and more specialists equals higher costs, more injury, more death and lower quality.
Medicare Answers
Temescal Creek Medicine accepts Medicare insurance for established patients. Payment for services not covered by Medicare is due at the time of service. Medicare will usually submit uncovered services to your Medicare Secondary if you have it. Uncovered charges will be billed to your credit card on file.
NOTE: Unfortunately, we are currently not accepting new Medicare patients.
No Insurance - No Problem!
Temescal Creek Medicine offers transparent, reasonable pricing for visits and services. A little investment in good primary care can avoid much more costly emergency care or hospitalization. We can also help direct patients to the lowest cost medication options. If you have further questions regarding insurance policies, please contact us at tcmadmin@tcreekmed.com.