Dr. Ross is a contracted PPO provider with many insurance plans, including, but not limited to Anthem Blue Cross, BlueShield, United Health Care, Aetna, Beech Street, First Health, Health Net, Humana, PHCS and Cedars‐Sinai Health Associates HMO.
However, this does not ensure coverage under your particular plan. As such, patients are responsible for confirming their own insurance benefits. You will be responsible for any payments denied by your insurance carrier.
Some or perhaps all of the services rendered may not be considered reasonable and necessary by your insurance carrier under your plan. In this instance, as the responsible party, you will be responsible for all charges your insurance carrier declines to pay for any reason.
Dr. Ross is NOT a provider for any insurance plans provided by the Affordable Care Act or Covered California.
Other payments that are patient responsibility, regardless of your insurance carrier, will include: co payments, co‐insurance, deductible and disallowed portion of any services.
Please sign below as your acknowledgement and understanding of this policy.