Insurance

AllergyMD Visit Insurance Guide

AllergyMD accepts most major insurance providers. Please contact your insurance provider to confirm if we are in-network with your plan.

We will try to review your insurance information before your visit, but it is ultimately your responsibility to confirm coverage with your insurance provider before your first visit.

To obtain this information, you will need:

• Your insurance card (member services phone number can be found on the back of your card)
• Name and DOB of the insurance policy holder
• Name of your Allergist: Dr. Tricia Lee
• Office address for your allergist: 150 E Ponce de Leon Ave, Suite 150, Decatur, GA 30030
• Office EIN/Tax ID: 93-1603027

When you call member services:

1. Let them know that you are planning to visit an allergy specialist, Dr. Tricia Lee, at AllergyMD.
2. Confirm that we are in network with your insurance plan.
3. Determine if referral from another physician is necessary.
4. Verify amount of copay.
5. Inquire about coverage for the following:
   • Office visit with an allergy specialist (codes: 99203, 99204)
   • Allergy testing performed in the office (codes: 95004, 95024, 95044)
   • Breathing tests in the office (codes: 94010, 94060)

** If you are subject to a deductible, you may want to request contracted prices for such services.

---

Important Questions to Ask About Your Insurance Coverage

Do I have coinsurance?

Coinsurance: A percentage of the cost of a covered healthcare service that you pay after you have met your deductible. For example, if your coinsurance is 20%, you will pay 20% of the cost of a covered service, and your insurance company will pay the remaining 80%.

Do I have a copayment?

Copayment: A fixed amount that you pay for a covered healthcare service, regardless of the cost of the service. For example, you might have a $20 copay for each doctor visit. The cost of the copay may be more because we are a specialist and if we are out-of-network 

What is my deductible and how much of it have I met so far?

Deductible: The amount of money you must pay out of pocket for covered healthcare services before your insurance company starts to pay. For example, if you have a $1,000 deductible, you will pay the first $1,000 of covered services yourself before your insurance company starts paying.

What is my out-of-pocket maximum?

Out-of-pocket maximum: The most amount of money you will have to pay for covered healthcare services in a single year. Once you have reached your out-of-pocket maximum, your insurance company will pay 100% of the cost of covered services for the rest of the year.