For PPO insurance plans, a referral is generally not required — though having one from your primary care physician can help with insurance coverage. Medicare patients do not need a referral. If your doctor suspects a rheumatologic condition, ask them to fax records to 760.753.0110. We are also happy to help coordinate directly.

We are in-network with Medicare, Blue Cross PPO, Anthem PPO, Health Net PPO, Aetna PPO, and Cigna PPO. Cash pay and self-pay are also welcome — a superbill is provided for out-of-network reimbursement. We do not accept HMO, Medi-Cal, Medicaid, or Workers’ Compensation plans.

We work hard to see new patients promptly. If your situation is urgent — acute joint swelling, suspected early inflammatory arthritis, or steroid-dependent symptoms — please tell our team when you call. We prioritize these cases and will do our best to get you in quickly.

Dr. MacLean will take a thorough history of your symptoms, review any prior labs or imaging, and perform a physical examination. She will share her initial impressions and outline a clear plan before you leave — you will never walk out of your first appointment without knowing exactly what the next steps are. Telemedicine is available for appropriate new patient consultations.

Yes. We use Doxy for secure, HIPAA-compliant video visits. Telemedicine is ideal for follow-up appointments, medication reviews, lab discussions, and patients throughout California who cannot easily travel to Encinitas. Some visits — including new patients with joint symptoms requiring examination, and infusions — require an in-person visit.

Absolutely. Prior authorization and step therapy barriers are one of the most frustrating realities our patients face — and one of the areas where an independent practice can advocate most effectively. Our team is experienced in prior authorization management, appeals, and working with specialty pharmacies to get your medication approved and in your hands as quickly as possible.