Billing and Insurance

We accept the following insurances:

• Medicare Part B
• PPO plans (out-of-network) including Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, and United Healthcare

The following insurance is not covered:

• HMO and EPO plans
• Managed care plans (including: SCCIPA, Santa Clara Family Health Plan, Brand New Day)
• Kaiser
• Worker’s Compensation
• Car accident liens

As a courtesy, we verify your coverage prior to scheduling and provide an overview of your coverage and the cost. However, since we are out-of-network with PPO plans, we do not have insight into how your plan might reimburse.

It is the patient’s responsibility to understand their insurance coverage. If you have questions after receiving our estimate, we encourage you to contact your insurance company.

• We collect patient payments at the end of each visit. Payments can be made via credit card (Visa, MC, AMEX), personal checks or cash.
• Vortex submits claims to your insurance company for processing. You should receive the Explanation of Benefits (EOB) from your insurance company within 30-45 days after the claim is submitted.
• If we owe you a refund or you have a balance due, we will provide you with a statement.

If you have questions about your insurance coverage or payment obligations, please contact our office manager at (408) 540-7622.

Private Pay

We offer a 25% discount to those who do not have any insurance coverage here or have a high deductible and do not want to go through insurance. Please contact our office for more information.

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our number on our website for more information.