Dr. Sharon Sims , APRN
High MarkupHigher Out-of-Pocket Billing Risk
This practice submits charges that average 7.3 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. Sims 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. Sims's submitted charges are significantly higher than peer medians (over 7.31x 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 J3111 | 24,570 | $42.78 | $20.00 | $9.84 | 2.14x |
HCPCS J1745 | 5,980 | $399.75 | $129.00 | $33.63 | 3.1x |
HCPCS J0129 | 4,350 | $237.58 | $80.00 | $39.44 | 2.97x |
HCPCS J1602 | 3,850 | $140.56 | $42.00 | $13.52 | 3.35x |
HCPCS J3245 | 2,400 | $663.54 | $295.50 | $136.64 | 2.25x |
HCPCS J0897 | 1,080 | $81.19 | $41.68 | $23.03 | 1.95x |
CPT 96372 | 354 | $461.69 | $46.56 | $12.02 | 9.92x |
CPT 96413 | 223 | $2872.51 | $429.62 | $114.93 | 6.69x |
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👨⚕️ 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: 7.31x. 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. Sims 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.