About Optimus Medical Group


 

What do I do in case of an after-hours emergency/urgent need?

If you are having a life-threatening emergency (examples: chest pain, severe breathing problems, shock, major trauma or loss of blood) call 911 or go directly to the nearest emergency room. This applies 24 hours a day.

If you're having an urgent medical issue after business hours, please call our after-hours nurses line at 415-286-9680 and the on-call physician will be paged.


How do I make an appointment?

Please call the office at 415-397-0700 and speak to one of our staff. Current patients may log in to Follow My Health and request an appointment.


How long must I wait to get an appointment?

New patient appointments for routine care or an annual checkup may require a longer wait time. The physician is often booked 2 to 3 months in advance for this type of appointment. Our physician assistants (PA) however may be available within one to two weeks. Routine maintenance appointments for established patients may require a 2 to 6-week wait with the position and 1 to 2 weeks with the PA. Urgent care appointments are available the same or next day with one of our providers in the office. If you need a follow-up appointment we encourage scheduling it before leaving the office.


What is a Physician Assistant?

A physician assistant, or PA, is a licensed and highly skilled health care professional, trained to provide patient evaluation, education, and health care services. A PA works with a physician to provide medical care and guidance needed by a patient.


A PA performs many of the same diagnostic, preventative, and health maintenance services as a physician. These services include, but are not limited to, the following:

    • Taking health histories
    • Performing physical examinations
    • Ordering X-rays and laboratory tests
    • Ordering respiratory, occupational, or physical therapy treatments.
    • Performing routine diagnostic tests
    • Establishing diagnoses
    • Treating and managing patient health problems
    • Administering immunizations and injections
    • Instructing and counseling patients
    • Providing continuing care to patients in the home, hospital, or extended care facility
    • Providing referrals within the health care system
    • Performing minor surgery
    • Providing preventative health care services

 

  • Actin1: as first or 5econd assistants during surgery

 

  • Responding to life-threatening emergencies


Is a PA licensed by the State of California?

Yes. To practice in California, each PA must pass a rigorous national examination before being licensed by the Physician Assistant Board, which is part of the California Department of Consumer Affairs.


What insurance is accepted?

We accept many private insurance plans, including HMO's and most PPO's. If you have an HMO, please make sure to select Brown and Toland as your medical group and Dr. Shawn Hassler as your primary care physician. We also accept Medicare but only accept Medi-Cal as secondary insurance. We also can accept self-pay. We are not contracted with Kaiser Permanente, HealthNet EPO, Blue Shield PPO or Blue Shield HMO. If you have a combined Blue Cross/Blue Shield plan please contact insurance directly to verif{our network participation.


The HMO plans we are contracted through Brown and Toland are:

  • Aetna HMO
  • Anthem/Blue Cross HMO (CaliforniaCare) CIGNA HMO
  • HealthNet HMO/HealthNet Seniority Plus PacifiCare HMO
  • SCAN
  • United HealthCare HMO

 

Our contracted PPO insurances:

  • Aetna Blue Cross
  • CIGNA/Great West HealthNet Medicare Part B MultiPlan PacifiCare
  • PHCS
  • United Healthcare


**Optimus Medical Group is not contracted with Workers Comp nor Motor Vehicle Accident Insurance (MVA)**


What do I need to bring on my initial visit? When do I need to arrive?

If you have not already filled out your new patient paperwork (you can download this from our website) we request that you arrived 30 minutes prior to your appointment to complete your paperwork. If you already completed your paperwork, please arrive 5-10 minutes ahead of time. Bring your paperwork and insurance card and ID with you. If you do not have a card, we will need the name of your insurance carrier and a phone number to verify your coverage. If we cannot verify your coverage we will require payment at the time of your visit. Once we have received payment from your insurance carrier, we will refund you the appropriate amount due. You should also be prepared to pay your co-pay at the time of service.

What if I have a billing question?

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Optimus Medical Group has contracted with 2f9"1R and-Tslaml BRS flil'iog SeQtices If you have a billing question, please call 415-972-4500


For your convenience, online payments may be made at instamed.com/optimusmecj or mailed to our office mailing address 870 Market Street, Suite 600 San Francisco, CA 94102


What is Timely Billing?

our office has 60-90 days to submit claims to insurance companies. If you feel there was an error with your claim submission, please contact Brown and Toland PPS Billing 415-972-4500 immediately. Depending on the insurance company, we have 60-90 days to resubmit a corrected claim. We do not take responsibility for failure to contact us within a timely manner.


Q&A: Routine Preventive Exams (Annual Physicals}

What is the purpose of a routine preventive exam (annual physical)?

The purpose of a routine preventive exam is to identify potential health problems in the early stages when they may be easier and less costly to treat.


What is the definition of a routine preventive exam?

A routine preventive exam is technically defined as periodic comprehensive preventive medicine evaluation and management, and includes the following:• Past medical, social and family history• Complete physical exam and review of body systems• Review of medications• Immunizations• Counseling/anticipatory guidance/risk factor reduction interventions • Review of age/gender appropriate screening tests • The exam is prevention focused, not problem focused.


Why did I receive a bill after my routine preventive exam when it was supposed to be covered at 100%?

This exam is prevention focused, not problem focused. If you have a new health problem or other diagnoses that need to be addressed during your preventive office visit, e.g. high blood pressure, diabetes, skin rash, or headaches, your provider may bill part of the exam at 100 percent for your annual preventive exam and part of your office visit for treatment of your diagnosis. The portion of your visit related to the treatment of your diagnosis would apply toward your deductible and coinsurance. If your provider feels that the majority of the time was spent with medical concerns, the entire visit may be considered a medical treatment visit and would not be billed as preventive. It's important to note that your healthcare provider has the right to code and bill as they see the service from his or her viewpoint.


Will my provider address only what my health plan covers for a routine preventive exam?

Your provider does not know your health plan benefits and sees many patients with various insurance plans throughout the day. You are responsible for knowing what services are covered under your health plan. Review your Summary of Benefits prior to your preventive exam or call Customer Service for your benefit information.


What can I do to make sure I receive my routine preventive exam benefit (100% coverage in-network)?

You can take the following steps to help ensure your routine exam is billed correctly:


    1. When scheduling your routine preventive exam with your provider's office, use the terms "routine preventive

exam" or "annual physical", not "check-up", which implies checking up on a health problem.

    1. When you talk with your provider, let them know you are there for your routine preventive exam.
    2. If you bring up health problems (i.e. skin rash) during your routine preventive exam, understand that you may have a charge related to the treatment of that problem.
    3. Do not save up all of your health concerns for your routine preventive exam. If you have a current chronic condition, you may need other diagnostic visits & services during the year.



What is your medication refill policy?

If your prescription is out of refills, please contact your pharmacy directly or log in to Follow My Health and request the refill. In turn they will either fax us or contact us directly through the EHR (Electronic Health Record) for a refill authorization. Please plan and allow at least 1 to 2 business days for refills to be approved.


Controlled prescriptions  are medicines that may be habit-forming or have severe side effects, including pain medication or sleeping pills. Testosterone and anabolic steroids are also controlled substances. Any controlled substance will likely take longer to process. Allow 72 hours potentially for these medications, as your record is often checked for your refill pattern. If you take controlled medications regularly, we acquire regular office visits. If you are on a Scheduled 11 medication, you will acquire a monthly visit at minimum if this medication is still being adjusted. If you are stable and without changes, we still require visits every 2 to  3 months. All Scheduled II prescriptions require a hard copy and cannot phone or fax submitted electronically. You must come to the office to pick up this prescription unless alternate arrangements have been made. If you were on maintenance controlled medication Schedule 111 or lower, we will require a visit at minimum every six months for refills. This includes most sleep aids, testosterone therapy, and most pain medication. Other maintenance prescriptions may require labs for a visit every 6 to 12 months depending on the medication, such as blood pressure and cholesterol medications. Some medications need to be monitored even more often for refills.


What if my prescription is not covered by my insurance?

Insurances now have drug formularies. Medications that are on the formulary are covered. If the medication is not on the formulary, we may be able to submit a prior authorization to request coverage. The pharmacy will notify us directly if your medication needs prior authorization. Please allow an average of 7-10 days for prior authorizations. Even if we complete a prior authorization your insurance plan may still deny coverage, we do not have control over this matter. If the medication is approved, it may require a higher co-pay then medication that is on your formulary. This is dictated by your plan. Every plan has its own formu\ary which can change throughout the year.


How do I get my lab results?

Often lab results are discussed in follow-up visits with your provider. If it is not necessary for you to make a follow-up appointment, we will contact you regarding any abnormal lab values that require attention. Basic lab tests are usually back in 2 to 5 days. SOIJle specific test may take 10 to 14 days. You may also log in to Follow My HeaIth. Due to various states restrictions, results will not be released through the portal.


What is the Follow My Health patient portal?

The patient portal is a way for you to securely access your personal health information and communicate with your health care team regarding your medical care. Some examples include:


    • Lab results
    • Medications
    • Allergies

 

  • Immunizations

 

  • Vital signs (blood pressure, pulse, temperature, etc.)


If you're a patient of Optimus Medical Group, you also have the ability to send a message to your provider anytime. Messaging allows you to:

  • Have time to think about what you want to say to your doctor
  • Tell your doctor something you forgot during your appointment
  • Let your care team know how you are doing with your care plan or tell them about any recent health changes
  • Ask about minor health concerns


What about privacy?

The Follow My Health patient portal comes with security protections to keep your health information private and safe. Some protections include:

  • Secure, encrypted and password-protected connection and access -This ensures your private health care information is safe from unauthorized access
  • Audit Trail - Keeps a record of who accessed your information, what changes were made and when


  • Password protection - Always remember to protect your username and password from others. Make sure to only log-on from a personal or secure computer


Who can see my health information?

Associated providers and their clinical staff. Other patients cannot see your information.

.. Remember, the portal is not for urgent care issues and does not replace appointments or full examinations.**

Location
Optimus Medical Group Inc
870 Market Street, Suite 600
Union Square

San Francisco, CA 94102
Phone: 415-483-4291
Office Hours

Get in touch

415-483-4291