A Notice to Our Patients with Mission Heritage / Providence / St. Joseph HMO Insurance
Effective February 1, 2026, Dr. Sohn and his team will no longer be contracted with Mission Heritage Medical Group or Providence St. Joseph Health HMO plans.
We will still gladly care for Mission Heritage and Providence patients, but after this date, visits and surgeries will be considered out-of-network (OON) and therefore self-pay.
Please note that HMO plans do not offer out-of-network reimbursement-payment in full is required at the time of service.
Mission Heritage / Providence HMO – Frequently Asked Questions
Q: Are you still seeing Mission Heritage / Providence HMO patients?
Yes. You are welcome to continue your care with Dr. Sohn. However, as of February 1, 2026, these visits will be direct-pay since Mission Heritage / Providence HMO plans do not include any out-of-network benefits.
Q: Can I still have surgery with Dr. Sohn?
Yes. You may choose to have surgery with Dr. Sohn by paying his professional (surgeon's) fee directly.
Whenever possible, we will schedule your procedure at Mission Hospital or another in-network facility so that the hospital, anesthesia, and implant charges remain covered by your HMO.
This means that only Dr. Sohn's professional fee is paid out-of-pocket, while the majority of other surgical costs stay in-network.
Q: Will I be reimbursed by my insurance?
No. HMO plans do not provide out-of-network reimbursement. All payments to our office are final and patient-responsible.
If you have a secondary PPO plan or Health Savings Account (HSA/FSA), we will provide detailed receipts for your records.
Q: What if I recently had surgery while you were still in-network?
If your surgery took place before February 1, 2026, we will continue to include all postoperative visits for six months after surgery at no additional charge, even after our contract ends.
After six months, any further visits will follow our direct-pay rates.
If you experience complications, delayed healing, or financial hardship, please contact us-we will always do our best to work with you.
Q: How long are follow-up visits included after surgery now?
- For surgeries performed on or after February 1, 2026 (out-of-network): Your surgical fee includes all follow-up visits for at least six months, often extended to nine months at no extra cost.
- For surgeries performed before February 1, 2026 (in-network): We will honor six months of postoperative visits as a courtesy during this transition, even though your HMO's standard coverage period was 90 days. After that period, any visits will follow our direct-pay rates.
Q: Why are you leaving the Mission Heritage / Providence HMO network?
We are making this change to improve the quality, efficiency, and scheduling flexibility of surgical care.
By stepping out of HMO restrictions, Dr. Sohn can provide a higher level of personalized treatment and operate at facilities best suited for each patient's needs-while maintaining transparency in pricing.
This change is also part of our broader effort to transition away from traditional insurance billing. Over time, the administrative and financial limits of HMO and insurance-based systems have made it increasingly difficult for independent practices to provide the time, access, and personalized care our patients expect.
Our goal is not just simpler billing-it's a more sustainable way to deliver excellent care. Moving toward a direct-pay model helps us stay independent, maintain quality, and keep our focus where it belongs: on patient care, not bureaucracy.
Q: What if I can't afford out-of-pocket care right now?
Please reach out to our office. We understand that this transition may be challenging and can discuss payment options or phased treatment plans. Our goal is to ensure you receive the care you need, not to turn anyone away.
Need Help Understanding Your Options?
Call or email manager@ocahealth.com for individualized guidance about your care, fees, and scheduling after February 1, 2026.