Office Hours

Dr. Weiner's office is opened Monday, Tuesday, Wednesday, and Friday from 8:30 a.m. to 5:00 p.m. On call services are available during the time the office is not opened for emergencies. Interpretive services are available for their Spanish-speaking patients.

What to Bring to Your Appointment

• Your insurance card
• A list of current prescription or over-the-counter medications you are taking, including dose and frequency
• Pertinent information about your medical and surgical history, including any pertinent x-rays or records you may have
• Forms the office may have sent to you, including:
  • BPH Symptom Index Questionnaire

Insurances

• Medicare (non participating)
• Most HMO and PPO plans

We are happy to process insurance forms when we contract with your insurance as long as you have provided us with the appropriate information. We expect payment promptly if you receive a bill from our office for balances that may be due. Please feel free to discuss any questions you may have about billing with office staff.

Dr. Steve Weiner is a provider for most major insurance plans. However, it is in your best interest to check your insurance providers list of participating physicians to be sure your plan allows you to be seen at our office. Also, please review with your insurance customer service representative (or insurance provider) the rules and limitations on coverage and reimbursement.

Hospital Privileges

• Boulder Community Hospital
• Portercare Avista Hospital
• Longmont United Hospital
• Platte Valley Medical Center
• Presbyterian/St. Luke's Hospital

Referrals - Things You Need to Know

Referrals from your Primary Care Physician (PCP) are processed based on product type. Listed below are various product types and whether your PCP directs your care or if a referral is required for services to a Specialist or for physical, speech, or occupational therapy.

• HMO - Health Maintenance Organization
  Health Maintenance Organization or HMO products require that a patient select a PCP and that the PCP directs the patient's care. Anytime a patient needs to be referred to a specialist, not only does the patient need the verbal authorization to go, they also need an authorization number from their health plan. The authorization number is obtained by the PCP's office phoning or faxing a request to the health plan. The authorization number consists of a certain number of visits during a specific time frame for a particular diagnosis and for a stated physician. This information must be presented to the Specialist or therapy entity when scheduling your appointment and should consist of the following:
  1. Your PCP's name
  2. Number of visits
  3. Date the referral begins
  4. Date the referral expires
  5. Authorization number
  6. Diagnosis
  7. Name of the physician or therapy entity you are being referred to
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• POS - Point of Service
  Point of Service or POS products work very similar to an HMO product in that it requires that a patient have a PCP, and for the best reimbursement level, an authorization number for a referral from their health plan for services to a specialist or therapy entity. A POS patient may self refer without involving their PCP, however, they may receive a significantly reduced benefit or reimbursement level.

• EPO - Exclusive Provider Organization
  Exclusive Provider Organization or EPO products require that a patient have a PCP and that the PCP directs all aspects of the patient's care. No services by other providers, in or out-of-network, are usually covered unless approved or directed in advance by the patient's PCP. An authorization number for a referral from their health plan for services to a specialist is required.

• PPO - Preferred Provider Organization
  Preferred Provider Organization or PPO products do not require a PCP or referrals. Patients select recognized physicians and usually will receive a preferred benefit level if they select a participating provider. Patients simply schedule an appointment with a recognized physician as noted in their directory for their best reimbursement level. Patients self refer.

• Indemnity
  Traditional Indemnity Plans or products allow patients completeflexibility in their choice of physicians. Patients are responsible for their care (no PCP directs their care), initiating precertifications for surgeries or outpatient services, and for submitting their claims for reimbursement.

Remember, if you change health plans, referrals do not transfer. You must obtain a new referral with your new health plan.

Know Your Benefits
Due to the various benefit plans and packages that each health plan may offer, it is impossible for us to know your specific benefit package. Your insurance plan is an arrangement between you and your insurance company. It is your responsibility to know your benefits, including which physicians are in your network or directory, which hospitals, laboratories, radiology facilities, etc., you can use for services.

Referral Procedures

• Obtain not only a verbal authorization from your Primary Care Physician (PCP), but also a referral authorization number must be obtained from your health plan. This is done by your PCP's office phoning or faxing a referral request to the health plan. The PCP then receives a referral authorization number for services to a Specialist or a therapy entity if you have an HMO, EPO, or POS product.
• The referral information that the PCP obtains from the health plan must contain the following information:
  1. Name of your PCP
  2. Number of visits authorized
  3. Beginning date of the referral
  4. Expiration date of the referral diagnosis
  5. Specialist's name or therapy entity's name
  6. The authorization number
• When scheduling your appointment with the Specialist or therapy entity, you need to make them aware of your referral and have them document the referral information (be sure to include all the information noted above.
• Please note that failure to follow these procedures may lead to significant financial obligations on your part.