What pricing options are available? add

We offer a Pay As You Go pricing option that's best for new patients or for people who require 1-2 visits per year and Monthly Memberships that are best for conditions that require frequent monitoring and easy access to your healthcare provider. We've made medical bills easy with our app through Repeat MD, and we also offer flexible pricing options through Affirm. Visit our pricing page for more information about our direct payment model.

How does the direct care, direct payment model benefit patients? add

Our direct care, direct payment model eliminates the middlemen so that we can make healthcare easy again and ensure you're getting the compassionate care you deserve. Exceptional patient experience is at the forefront of what we do. When you make Pazona MD your partner in health, you'll have shorter wait times for visits, appointments that don't feel rushed, simple and transparent pricing, email and text access with your provider, flexible financing options, same-day visits, and so much more. With rising deductibles and out-of-pocket expenses, a direct payment visit with Pazona MD might even be less expensive than using your insurance. Put yourself and your health first and let us work with you to create a comprehensive care plan that's right for YOU.

What is a direct care / direct payment model? add

We provide the healthcare you deserve and you pay our practice directly for our services. A direct care / direct payment model removes insurance companies from impacting your healthcare decisions. No greedy middlemen who take money out of the system for profits. No prior authorizations. No denials. No surprise bills. We make healthcare affordable and easy.

What does it mean that you're "out-of-network" with my insurance? add

Medical practices typically sign contracts with insurance companies to care for patients at fees set by the insurance company. When a practice does this, the providers are considered “in-network” with that specific insurance plan. An “out-of-network” provider has decided not to contract with that insurance company.

Can I submit my bill to my insurance company for reimbursement? add

If you have out-of-network benefits, then you are entitled to submit your own claim to the insurance company. We can provide you with a “superbill” but we will not be involved in the reimbursement process. We cannot guarantee reimbursement from your insurance company.
If your insurance plan requires you to see in-network physicians/providers then you will not be able to submit our fees for reimbursement through your insurance plan.

Do I have to pay for my visit at Pazona MD? add

Yes. Payment for medical services is expected at the time of the visit. However, we offer a number of convenient ways to pay for your medical services. You can choose a monthly membership option which provides access to our medical team for a monthly fee. We also work with Affirm, the largest financing company who partners with Amazon, to provide financing at low interest rates. Lastly, you can still use your FSA (flexible spending account) or HSA (health savings account) cards for eligible purchases.

Can I use my medical insurance to pay for medications, labs, and imaging etc? add

Yes. You can still use your medical insurance to pay for medications and services with other medical vendors (e.g. Premier Radiology, Quest labs, pharmacies and hospitals). We can also assist you in finding less expensive medications and imaging studies outside of insurance.

Can I use my insurance to pay for surgical procedures? add

Procedures in our office will require payment to Pazona MD. We offer financing options or you can use your FSA/HSA cards. For surgical procedures performed at a surgery center or hospital, there are typically three different entities requiring payment:

  • Pazona MD (professional surgical fee)
  • Hospital/surgery center (facility fee)
  • Anesthesia Department

You will be directly responsible for paying the professional surgical fee to Pazona MD. You may still use your insurance to pay for facility and anesthesia fees. Your out-of-pocket expense to the hospital/surgery center/anesthesia department will vary depending on your insurance plan. We can assist you in determining this amount.

Why are you out-of-network with my insurance plan? add

When a provider is in-network they must provide medical care at the rates/fees set by the insurance company. These rates have not increased in any substantial way to keep up with inflation. At the same time, the cost of running a medical practice has dramatically increased.
Rising Costs + Declining Payments = Closed Business
Therefore, the only way medical practices can remain in-network with insurance and stay in business is to:

  • See more patients in a shorter amount of time.
  • Invest and promote ancillary medical services (e.g. surgery centers, CT/MRI).
  • Sell to a large corporate entity (e.g. hospital system, private equity firm).

At Pazona MD we believe these factors compromise the patient experience. You should spend as much time with your doctor/provider as necessary. Doctors shouldn’t be incentivized to “do more stuff” to patients to remain profitable.
As an alternative, we have decided to opt out of insurance and directly serve you. We now can offer transparent pricing with multiple financing options, so you can receive an exceptional experience and medical care without any barriers.

But I already pay money for my medical insurance. Why should I have to pay Pazona MD as well? add

Having medical insurance does not guarantee that you will have no additional out-of-pocket expenses. Even if your employer is covering your insurance premium, many insurance plans still have a high deductible or out-of-pocket expense that you are responsible for paying. For example, 2/3 of our patients undergoing vasectomies still paid 100% of the fee despite having insurance coverage.
Additionally, you are paying for convenience, expertise and an exceptional experience at Pazona MD. Unlike other medical practices we:

  • Guarantee visits on the same day.
  • Are the highest-rated medical practice in the Southeast with over 1000 five-star reviews.
  • Led by board-certified urologists and practitioners with over 75 years of experience.
  • Offer transparent pricing with no surprise bills.

I'm already a patient of Pazona MD and insurance was covering my costs. Do I now need to pay to see a provider? add

Yes. Since we are no longer in-network with any insurance plans, we cannot bill your insurance company and you will be responsible for any costs associated with our services as of January 1st, 2025.

What if I had surgery with one of your surgeons prior to January 1st, 2025 and I need post-operative care? add

If you had surgery with a Pazona MD urologist within the last 90 days of 2024, we will be happy to provide any post-operative surgical care for no additional fees. If your surgery was prior to October 1st, 2024, and you still have active medical issues, then you will be required to directly pay Pazona MD for additional care/services.

What about Medicare and Medicaid? add

We are no longer accepting new Medicare patients. If you are an existing Medicare patient (not Medicare Advantage), we are unable to continue providing any coverable services at this time. We are happy to assist you in finding another urology provider in your area to continue your care.
If you have Medicare, and are interested in our hormone optimization and wellness plans (non-coverable services), then we’d be happy to see you for a free consultation.
We are out-of-network with all Medicaid plans. All services require direct payment to Pazona MD.
You will not be able to submit or receive reimbursement from Medicare or Medicaid for services from Pazona MD.

What if I’m already a monthly member of the Pazona MD Weight Loss or Hormone Optimization plans? add

What if I’m already a monthly member of the Pazona MD Weight Loss or Hormone Optimization plans?

Should I still keep my medical insurance? add

It’s advisable for everyone to have some kind of insurance in case of catastrophic events (e.g. cancer diagnosis, car accident). Most people choose traditional insurance plans to help limit all of their medical expenses. However, there is an alternative model known as medical cost sharing plans. These plans function like an insurance policy except they are:

  • Less expensive than traditional insurance plans.
  • Not attempting to profit off of your health at all costs.
  • Help negotiate the best cash prices for your medical care.

Medical cost sharing plans like Sedera (https://sedera.com/) and Zion Healthshare (https://zionhealthshare.org/) have been around for over a decade. If you’re less than age 65 and are tired of paying high premiums and deductibles for health insurance, we recommend you check them out.