Insurance

At South Bay Vascular, we are committed to enhancing the quality of your care and overall experience with us. One way of achieving this is to establish clear communication regarding our policies and clear expectations of compliance with them.

Understanding how your insurance works and what your responsibilities are in relation to our financial policies is an important part of your overall care and experience.

When you schedule an appointment for our Campbell or Gilroy location, we are happy to work with your insurance company to check for coverage for visits and treatments. Many of the medical procedures and tests provided by South Bay Vascular are covered by insurance companies, though purely cosmetic treatments may not be covered.

We Go Above and Beyond.

We encourage all of our patients and inquiring patients to contact our front office with ANY financial/coverage concerns that you may have. You may also contact our billing department directly for more detailed information about your insurances and coverage. Our billing department is available Monday – Friday, 8:30-4:30 at
408-376-3626, ext 106.

What to Expect

Please note that regardless of the status of your insurance, each time you arrive for your scheduled office visit, you will be expected to sign in and to show your insurance card to the front desk before being seen by your provider.

Methods of Payment:

We accept cash, checks, VISA, and MasterCard. There is a $20 fee for any check that is returned.

Insurance Carriers

As a courtesy to you, South Bay Vascular will bill your insurance company for your office visits. However, it is your responsibility to provide us with complete billing information and your insurance card. You will also be responsible for paying your co-pay at each visit.

South Bay Vascular Center and Vein Institute is currently contracted to provide medical services with the following carriers. We are actively adding new carriers, so please call us directly to discuss your individual insurance carrier.

  • Aetna
  • Affinity
  • Blue Cross*
  • Blue Shield*
  • Cigna
  • Healthnet
  • Mail Handlers Benefits Plan
  • Medicare
  • Multiplan
  • SCIPPA- authorization required
  • United Healthcare
  • Verity (FORMERLY sjmg/dchs)

*Note: NOT contracted With: Covered California, Select PPO, Pathway PPO, some Gold, Silver, Platinum plans, IFP On-Exchange/Off-Exchange. Many of these plans may have a Covered California version of the plan; South Bay Vascular does not currently accept this insurance.

HMO Patients

It is your responsibility to get each visit authorized by your primary care doctor. HMO’S do not reimburse out-of-network providers, which means that as the patient, you are responsible for the full amount charged by your doctor. All HMO patients need a referral from their primary care physician before we can see them in our practice.

Please keep track of the number of visits authorized and when they expire. If you are seen by Dr. Kokinos and you do not have an authorization, or your authorization has expired, or the number of visits has been exceeded, you will be responsible for payment for your office visit.

Medicare vs. Medicare Advantage

When you assign your Medicare benefits to an HMO, you no longer have to pay co-insurance fees. This kind of insurance plan is known as Medicare Advantage. Unfortunately, Medicare Advantage puts strict limits on your choice of doctors and allowable procedures. Only doctors in-network or contracted with your HMO can see you, meaning that you may need to change your current doctor. SBVC only accepts Medicare Advantage affiliated providers SCCIPA and AFFINITY, and only with a pre-authorization and referral letter from your primary care physician.

Missed Appointments and Cancellations

To provide the best treatment to all of our patients, we reserve the right to charge for any missed appointment that is not cancelled in advance. Our fees change on the type of appointment; see table below for more information.

  • Office Visit: $75 if cancelled less than 48 hours in advance
  • Ultrasound: $100 if cancelled less than 48 hours in advance
  • VNUS/EVLT: $200 if cancelled less than 1 week in advance
  • Outpatient Angio: $200 if cancelled less than 1 week in advance

Billing FAQ

What is a deductible and coinsurance?

In an insurance policy, the deductible is the amount of expenses that must be paid out of pocket before an insurer will pay any expenses. Most deductibles renew on an annual basis and begin in January with services covered under the calendar year. Some insurance carriers allow for a last quarter “carry-over,” whereby services during the last quarter of the year can be carried over and applied to the next year’s deductible. If you are unsure which you have., contact your insurance carrier. Once a deductible has been met, many plans still have a coinsurance or copayment amount, which is the patient’s responsibility.

What is a Co-Payment?

A co-payment is a fixed amount you are required to pay for each medical service you receive, regardless of the cost of the service. Unlike a deductible that’s usually paid one a year, a co-pay is paid EVERY time a health care service is used.

What is meant by “Out of Network”?

A provider who has not contracted with your insurance company for reimbursement at a negotiated rate is referred to as an “out of network” provider. Out of network patients will be charged at self-pay rates. Some “out-of-network” patients have the option of billing their insurance so that when they are paying it will go towards their deductible.

What is an out-of-pocket maximum?

This is a predetermined limited amount of money that an individual must pay, before an insurance company will pay 100 percent for an individual’s health care expenses. Frequently, this exceeds the deductible amount.

How do I know what my benefits include?

We encourage our patients to contact their insurance companies and become familiar with their plan benefits. Each policy is different, and we cannot quote insurance benefits. However, for special procedures that require pre-authorization, we will work with your insurance company to obtain approval.


Healthcare Information and Patient Responsibility

It is the patient’s responsibility to immediately communicate any change in their health care information to the front office. Health care information includes the following:

  • Insurance Information/Coverage
  • Responsible financial parties; adjusters/attorneys
  • Address
  • Telephone Number
  • Emergency Contacts
  • Fax/Email
  • Change of referring and/or primary care physicians
  • Any new symptoms since your last appointment

Thank you for understanding our insurance and payment policies. If you have any questions or concerns, please contact our Billing Department at 408-376-3626.

“I found Dr. Kokinos to be excellent at explaining, assessing, and treating. It is wonderful to find an excellent doctor who is also a friendly and compassionate person.”

– SBVC patient

“For over 12 months I went between UCSF and Stanford Clinics trying to get diagnosed because I was so ill...no one could ever find a cause to any of my symptoms....it turns out it was a blood flow problem that was making me so sick. I am very thankful I found Dr. Kokinos!”

– SBVC patient