Frequently Asked Questions

BCBS of New Mexico:

Federal Employees, Commercial packages (HMO, POS & PPO), Medicare Advantage (HMO & PPO)

 

CIGNA

All packages (PPO & Open Access)

 

CHRISTUS HEALTH

All Commercial packages and Medicare packages

 

HUMANA

All Commercial packages and Medicare packages

 

MEDICARE (TRADITIONAL)

 

PRESBYTERIAN HEALTH PLAN

All Commercial packages (ASO/HMO, POS, PPO, PIC), Medicare/Senior Care(PPO,HMO,POS),

Centennial Care(Medicaid)

 

UNITED HEALTH CARE

All Commercial packages (HMO, PPO), Medicare Advantage (HMO, PPO), TriWest, AARP Medicare

Advantage (HMO, PPO), all Community packages (Medicaid, Medicare Advantage, HMO, PPO)

 

 

Additionally our providers participate in some group plans such as Ardent, Multiplan,

Networks and PHCS (Physicians Health Care Services). We will accept these insurance plans as a form

of payment or partial payment for most services.

Please be aware that if the providers of Caskey Medical Group are not participating providers in your

choice of health plan coverage, these services may not be reimbursed or may only be partially

reimbursed by your insurance company. There may also be services that you choose to have that

your insurance plan will not cover, this is based on your individual plan. For instance, some insurance

companies will not pay for a shingles vaccination though many patients choose to have one. 

Your insurance company may also choose not to pay for services rendered for a particular diagnosis for

which you choose to receive care. Ultimately you are responsible for payment for our services and

for understanding the limitations of your individual insurance plan. Many insurance policies

are currently undergoing significant changes. Check regularly with your insurance company

for any updates to your policy.

For additional questions about billing and payments, or for specific questions about your bill

please contact Lisa Sandoval at 505-428-0447

Your insurance policy determines the amount of your copay, and most plans now require a copay for each

office visit. We are contracted with your insurance company to collect these monies up-front, just as you

are contracted to pay these fees. Copayments are due at the time of service.

New patients should bring with them a government issued form of identification, their insurance card, a

list of current medications and allergies, and the completed new patient packet.  Your new patient

packet may also be uploaded and sent to us via our secure E-Forms service at least 24 hours prior

to your appointment time.  It is often useful to bring in all of your medications rather than listing them so

that we can verify the dose and frequency of your prescription and any medications that you may be

receiving from other providers.  Existing patients please remember to provide updates of your contact

information with every visit, and any changes to your family and social history, prescription

medications, or visits to specialists that have occurred since your last visit with us.

We welcome your decision to include a family member, caregiver or close friend in your care. 

Space is limited, but we will gladly work to accommodate whomever you choose to bring with you.

Please contact your pharmacy for all prescription renewals. Your pharmacy will then contact us to fulfill

your request.  You may call us after you have contacted the pharmacy to let us know that you have

requested a renewal, but if you call us first, we will request that you contact your pharmacy before

any action can be taken. This is the most efficient means of fulfilling most prescription

renewals. Ideally you should contact your pharmacy at least 1 week prior to the day that you will run out

of your prescriptions.  Generally, we will fax over or send an electronic renewal for medications 24-48

hours after we receive a refill request from your pharmacy. However we cannot control how long it

may take the pharmacy to process the request. Please allow time for contingencies.

Lab results are usually available within 5 business days. If you have not heard from us a

week following your tests, please contact us via the Patient Portal to inquire about your results.

Typically blood tests are connected to an office visit, and tests are performed just prior to or immediately

following a scheduled appointment. In most instances, you are not required to come in simply to review

the results of testing. Instead we will relay the results of testing via the Patient Portal. However in

some circumstances our providers will request that you come in for a detailed discussion of your results.

We may request that you make this appointment to ensure that you have the time to process the

results and ask necessary questions related to the findings and any follow-up that is warranted.

In order to best manage your health care, we require periodic visits to monitor your health and well-

being. These visits give us the opportunity to re-measure your vital signs, assess your general state of

health, and insure that you have received the recommended screenings appropriate for your age and

health concerns. Additionally, these visits are used to assess your medication regimen and any changes

that other doctors have made in your treatment plan. By scheduling these well-visits routinely, we avoid

having to schedule an office visit for a prescription renewal or screening test. We may ask you to

schedule a follow-up appointment to reassess the efficacy of a prescribed treatment plan. A prescription

is usually given for a certain amount of time, because this is judged to be the time frame in which the

medication will have a measurable effect or perhaps when worrisome side effects tend to occur.

At the end of this period, the effect needs to be monitored to determine whether the medication should be

continued or should be adjusted. Without such routine monitoring, medications may have unnoticed

adverse effects. Be sure to discuss with your provider what type of monitoring your medication

regimen requires, and how often you are expected to come in for follow-up or preventive visits.

 

Many insurance companies require prior authorization for more expensive tests and medications. A prior authorization request obliges us to get approval from your insurance company before they  will agree to pay for a particular test or treatment. Once we receive a prior authorization request form, we generally are able to complete and return this form to your insurance company within 1-2 business days. However, your insurance company may take an extended period of time, sometimes as many as 10 business days to process your requested medication or procedure. Please allow at least 5 business days before following up on a request that has already been submitted to us. In most cases an approval is given, but in some circumstances your insurance company is not in agreement with the requested service and the request is denied.