Insurance Coverage and Membership Options

The Center for Prevention Heart Attack and Stroke (CPHAS) is a fee for service consultation service.  Its mission is the prevention of heart attack and stroke.  Insulin resistance, prediabetes and Type 2 Diabetes are also managed.  

Many of our patients choose one of our membership inclusive packages to have predictable maximum out of pocket cost.  Insurance claims are submitted and offset the costs of membership.  Medicaid is not accepted as a form of payment. 

CPHAS is in network for some Blue Cross Blue Shield PPO plans, but out of network for all other insurers that have a network limitation on coverage.  In some cases, that means that there may be higher out of pocket costs for office consultations and any other services billed by CPHAS.  If labs, consultations or imaging studies are ordered, all efforts will be made to refer to in network providers.

Consultation recommendations and documents will be shared with your primary care physician and any appropriate specialists at your request.  The goal is collaboration with your other physicians. 

If we don't know your arterial health or disease, your first experience with CPHAS will be a Healthy Heart Screen (not covered by insurance but costs only $100). 

Your results will guide recommendations for either a Basic or Comprehensive Bale Doneen Assessment and ongoing management.  Insurance coverage for these assessments and management programs varies by plan and degree to which deductibles have been met.  

Dr. Backs offers a concierge primary care option known as Personal Medicine.  This comprehensive primary care service with enhanced access requires a membership fee paid annually. 

Membership in Personal Medicine is not necessary to receive the more proactive preventive approach for heart attack and stroke offered by CPHAS.