We are in our new space, seeing patients. Come check it out!

Cigna has announced this week that they will start downcoding physician notes automatically when they receive claims, starting in October. They did not disclose details of how they will decide which notes to downcode, but they did suggest that an AI would be involved. This will be done without reading medical records, to actually verify if the change is appropriate. This is unethical at least, and illegal in many states. They do allow for appeal of these decisions, but the process will be costly and lengthy to physicians that undertake it. 

We believe firmly that this will ultimately lead to a lot of physicians, especially specialists, dropping Cigna insurance. If you or a loved one has this insurance carrier, please call them and ask for them to reconsider this inappropriate decision. We hope they will reconsider before they create a disaster for many patients. 

To provide more information, all physician visits are basically a level 1, 2, 3, 4, or 5. The codes change based on the setting (hospital, ER, urgent care, outpatient), but that is the basic arrangement everywhere. The complexity of the case is determined by the provider/physician, and this is used to select the level applied. It is illegal for providers to upcode or downcode intentionally (either claiming more or less effort than was actually put into the visit). Historically, insurance companies would audit a record if they had reason to suspect it was upcoded by the provider. This move by Cigna announces these changes will take place without the appropriate audits. It should be illegal for them to downcode without actually checking the legitimacy of the change, since it is illegal to do this on the provider side. 

Notice to our Humana Medicare patients:

We are now out of network. We will not bill Humana any further. Anyone who wishes to keep their advantage plan as is, and continue seeing us, is welcome to do so as self-pay. Everyone has to evaluate whether this is the correct financial decision for them. We still take Blue Cross Medicare Advantage and the popular UHC Medicare Advantage plans. 

OPEN Monday, January 19th MLK JR Day

OPEN Monday, February 16th, for President's Day

OPEN April 3 on Good Friday

CLOSED Monday, May 25, for Memorial Day

OPEN Friday, June 19, for Juneteenth

CLOSED Friday, July 3rd, for Independence Day

CLOSED Monday, September 7, for Labor Day

OPEN Monday, October 12th, for Columbus Day

OPEN Wednesday, November 11, for Veterans Day

CLOSED Thursday and Friday, November 26-27, Thanksgiving

CLOSED Friday, December 25th, for Christmas. Also close early on December 24. 

CLOSED Thursday, January 1, for New Year's. Also close early on December 31. 

LIMITED AVAILABILITY the weeks of Christmas and New Year's, but not closed outside of the holidays (both Fridays)

Office hours 7am-5pm Monday through Thursday and 7am-3pm Fridays

Dr. Kyle appointments from 8am-4:40pm Monday through Thursday

Dr. Rebekah appointments from 7am-1:40pm Monday through Thursday

Dr Rick will see patients Tuesday 7am-4:40pm Tuesday through Thursday, and 7am-3pm Fridays starting December 1st

Mary Thompson appointments from 7am-4:40pm Monday through Thursday

Filippo Borsellino appointments 7am-4:40pm Tuesday through Thursday and 7am-3pm Fridays

Same day call-in slots (formerly walk-in) from 7am-4pm Monday through Thursday and Friday 7am-3pm

Nursing appointments 7am-Close for injections, labs, etc., but due to lab pickup time, labs must all be drawn 40 minutes earlier