About Resident Care
How often does a Physicians Eldercare clinician visit each nursing home or assisted living center?
At each facility we serve, the level of care we provide and the frequency of our on-site visits is determined by the needs of residents. In most cases, members of a Physicians Eldercare team visit a facility multiple times each week.
How can I contact a provider for an appointment?
Please contact your nurse in the facility where you or your loved one resides and request that an appointment with your physician, nurse practitioner or physician assistant be scheduled the next day they are in the facility.
Does Physicians Eldercare follow patients in hospitals?
No. Physicians Eldercare works with local physician practices to provide hospital services when needed and if a hospitalist is not available. These arrangements can provide a smooth transition between the hospital and the long-term care facility. The name of the Physicians Eldercare clinician and the telephone triage number should be included with the contact information that accompanies a resident to the hospital.
How are referrals to specialists made?
Physicians Eldercare relies on its physicians to recommend specialists to residents. Our clinicians respect the ultimate decision of the resident, family, and facility in making these decisions.
Who pays for Physicians Eldercare services?
Fees for Physicians Eldercare’s services are billed to the individual’s insurance company, Medicare Part B or Medicare advantage program, and/or to the individual themselves. The Patient Information Sheet, once signed by the legally responsible party, allows Physicians Eldercare to bill Medicare, Medicaid, or Medicare Advantage Plan along with a secondary and tertiary plan and to balance bill the patient if needed. PEC bills Medicare Part B plans. The patient’s Medicare Part A covers the facility stay. Part A benefit does not apply to PEC because we are Part B providers.
Will insurance cover the entire bill?
Most insurance companies do assign a patient liability for services, such as a co-payment or deductible. A call to the insurance company should provide an answer on eligibility and coverage. Physicians Eldercare is a contracted provider for Medicare, Medicaid, and most Medicare Advantage Plans such as Blue Medicare HMO and PPO. For these Medicare Advantage Plans the responsible party must notify the plan and request a change in the primary care physician. For help with questions, call Physicians Eldercare at (336) 251-1114, option 2, between 7:30 a.m. and 5 p.m.
Can the co-payment be waived?
Insurance companies and federal regulations require service providers to bill for co-payments. Failure to bill for co-payments assigned by insurance companies is considered insurance fraud. Physicians Eldercare is permitted, however, to waive co-payments on a case-by-case basis for individuals who demonstrate that they do not have the financial resources to pay the co-payment. For individuals who do not qualify for a waiver of co-payments, payment plans can be arranged by calling Physicians Eldercare at (336) 251-1114, option 2, upon receipt of the first bill.
What about self-payment?
Residents who are classified by the facility as self-pay may contact our billing office to make payment arrangements by calling (336) 251- 1114.