Are you still in-network with my insurance?
We remain in-network with several plans. Others are now out-of-network (OON) for Dr. Sohn's professional fees. The hospitals and surgery centers we use are in-network with most plans, so your facility and anesthesia charges are usually processed at your highest benefit level. Please call us to check your current plan status.
How does it work if you’re out-of-network?
We collect our full surgeon’s fee before surgery. We then submit a claim to your insurance (when allowed). If the insurer sends payment to us, we refund you any overpayment within 30 days. If they send payment to you, it’s yours to keep.
Will my insurance still cover anything?
Often yes. Even if Dr. Sohn is OON, the facility, anesthesia, implants, and many supplies are billed separately and often covered at your in-network rate.
What about clinic visits?
We collect payment in full at the time of service. If your plan allows, we will submit the claim for you. Any reimbursement goes directly to you (or is refunded by us if sent to our office). If we cannot bill your insurer, we give you a superbill so you can submit it yourself.
Do you get prior authorizations?
Yes, when permitted. A prior authorization is not a guarantee of payment.
What if I don’t have out-of-network benefits?
We offer transparent direct-pay prices for surgery and clinic visits.
Do you take Medi-Cal/CalOptima?
No. We cannot treat patients enrolled in Medi-Cal or CalOptima, unless you have a reassigned Medi-Cal/CalOptima HMO plan with which we are contracted.