Dr. Melissa Balbuena-Root , MD
Extreme OutlierHigher Out-of-Pocket Billing Risk
This practice submits charges that average 11.5 times customary allowable rates. If you have not met your annual health insurance deductible, or if this doctor is out-of-network with your health plan, you may face significant balance billing.
- Confirm network status: Call your insurer to confirm this specific physician and office address are in-network.
- Request in-network labs: Before blood draws or biopsies, ask the nurse to send samples exclusively to an in-network commercial laboratory.
- Ask for a written estimate: Under the No Surprises Act, you are legally entitled to a Good Faith Estimate if you are self-pay or out-of-network.
Balanced Practice
Maintains a steady clinical rhythm balancing focused physical examination with patient discussion.
How is appointment length calculated?
Visit durations reflect official documentation standards for Evaluation and Management (E/M) office billing codes (CPT 99202 through 99215).
Physicians who bill higher-level comprehensive visits (such as 99214 and 99215) consistently spend 30 to 45 minutes reviewing complex records and discussing care plans, whereas routine refill clinics predominantly bill briefer level 2 and 3 codes.
Appointment Length & Visit Style
Clinical appointment coding analysis across standard patient evaluations
Dr. Balbuena-Root primarily performs clinical procedures, imaging, or laboratory services rather than routine timed office consultations.
Pricing Transparency & Fee Comparison
How this provider bills compared to standard insurance benchmarks
⚠️ Price Outlier Warning: Dr. Balbuena-Root's submitted charges are significantly higher than peer medians (over 11.53x the baseline standard). If you receive treatment out-of-network or without insurance, you could face substantial bills. Confirm in-network participation with your health plan prior to booking.
Verified Clinical Procedures & Surgical Focus
Official annual procedure volumes, customary fee comparisons, and clinical focus areas.
| Clinical Procedure & Code | Annual Services | Doctor Charge | Peer Norm | Standard Baseline | vs. Peer Norm |
|---|---|---|---|---|---|
HCPCS G0453 | 1,828 | $157.31 | $150.00 | $30.79 | 1.05x |
CPT 95938 | 465 | $705.31 | $550.94 | $43.30 | 1.28x |
CPT 95937 | 447 | $162.79 | $282.00 | $33.10 | 0.58x |
CPT 95955 | 364 | $1475.07 | $1463.98 | $50.85 | 1.01x |
CPT 95861 | 306 | $1021.81 | $605.45 | $77.77 | 1.69x |
CPT 95939 | 219 | $1380.03 | $946.74 | $113.20 | 1.46x |
CPT 95870 | 194 | $162.11 | $377.00 | $18.70 | 0.43x |
CPT 95865 | 17 | $1381.42 | $1186.68 | $78.79 | 1.16x |
Other Neurology Doctors in Arizona
Explore peer practitioners in the same state
👨⚕️ Physician & Medical Billing Intelligence (Click to view professional coding data)Expand ↓
This section provides clinical practice analytics for healthcare administrators, billing coders, and peer physicians evaluating practice benchmarks:
Estimated appointment time calculation: N/A. Indicates the proportion of high-complexity (99205/99215) vs. moderate-complexity (99204/99214) documentation relative to national specialty peers.
Gross charge multiplier: 11.53x. Useful for fee schedule alignment, out-of-network charge master analysis, and payer contract negotiations.
Patient Guidance: What to Ask Before Your Appointment
- In-Network Confirmation: Confirm directly with your insurance plan that Dr. Balbuena-Root participates in your specific network tier.
- Surgical Facility Fees: If having surgery, verify whether it will be in a hospital or an outpatient surgery center. Facility charges are billed separately from physician fees.
- Written Estimates: If you are paying out of pocket or have a high deductible, request a written good-faith estimate before major treatments.