FINANCIAL INFORMATION/POLICIES
Working with insurance companies has become increasingly difficult through the years. I have considered adopting a model that does not include insurance for many years, but I know how difficult that could be for many of you who rely on insurance to defray your health care costs. Therefore, I have made the decision to continue accepting insurance.
This decision requires a change to my financial policies, in order to continue to offer the high- quality level of care you have come to expect. Longer appointments create a need for low overhead, which we achieve by employing fewer support staff. The paperwork requirements of insurance companies create a need for additional staffing hours to manage the work. To absorb these additional overhead costs, we are moving to a model used in many integrative health practices. In order to continue using insurance, we are implementing an annual membership fee (details below).
Following are my updated financial policies. There is a very significant change, so whether you are a current patient or a new patient, PLEASE READ THEM CAREFULLY before signing off on them.
Here’s what you need to know before scheduling your first appointment:
1. We are currently accepting new patients.
We are booking new patients up to 2 months out in order to accommodate our established patients.
2. We do not have the same amount of support staff as a conventional medical practice.
We believe that you deserve as much time as you need, and choose not to place arbitrary time limits on our appointments. We focus on high-quality, integrative health care. This model requires us to have lower overhead, since we see fewer patients every day. One way to reduce overhead costs is to have fewer support staff.
This means that you will be required to take an active role in your healthcare. Patients must promptly pay all invoices and membership fees to continue working with their provider. Invoices will be sent to your email with a clear explanation of charges and visit date.
3. We accept the following insurance plans:
Aetna
Blue Cross/Blue Shield
Cigna
HPHC
Martins Point
MCHO
Medicare
UHC
We are also credentialed with: HPCP, Cigna, and Anthem healthcare exchange plans (Obamacare plans).
If you are unsure whether we accept your insurance, please call our office to verify BEFORE scheduling a new patient appointment. If you schedule an appointment, and we do not accept your insurance plan, you will be billed the cash rate for your visit (as noted below).
4. If you choose not to use insurance coverage, our self-pay rate is $160 per hour. All time, such as e-mail and phone assistance for health care concerns outside of a regular office visit, will be billed at this rate to a card on file unless you choose to pay the membership fees which entitle you to these services.
To use insurance at our practice, an annual membership fee is required. Details are below – please read CAREFULLY to be sure that you understand what this means for you financially.
5. An annual membership fee, beyond your insurance premium, deductible, copay and/or coinsurance will be charged all patients who use their health insurance plan at our practice.
The fee is $25/month or $300 annually. This fee covers all the extras that we provide that is not covered by insurance. It also helps us support the staff needed to meet insurance requirements. This fee keeps our practice viable, and allows us to continue accepting insurance and offer long appointments.
The fee must be auto-billed to a debit or credit card, either monthly or annually. This is an annual fee and is required each year that you are a patient at our practice.
This membership fee DOES NOT replace your insurance premium, deductible, coinsurance and copay. To have us bill insurance and be a patient in our practice, you will be required to pay the following:
Your insurance premium – what you (or your employer) pay each month for health coverage.
Your insurance deductible – the amount you are required to pay before your insurance will cover any portion of your healthcare costs.
Your insurance coinsurance – the percentage of the remaining costs you must pay after you reach your deductible Your insurance copay – a flat fee that you pay at each visit depending on your individual plan.
Your Annual Membership Fee – a membership fee charged by our practice. This fee is not refundable.
Our office will email you an invoice for all services not paid by insurance or paid at the time of your visit, then charge your card on file. We do NOT send invoices via snail mail. If you need a hard copy of your bill you can print the invoice from your email. As mentioned above, the invoice will note which visit and which services the charges are for. If you have questions regarding your health coverage it is best to call your insurance company. The support number can be found on the back of your card. Additionally, you will receive an EOB (Explanation of Benefits) from your insurance company prior to being billed by our office. This EOB explains what your insurance paid and did not pay based on your coverage.
6. You must have computer access to use our practice. We deliver all new patient paperwork electronically, and appointments and secure messaging happens through our Patient Portal. We prefer to use secure messaging for communication, and it is the primary way we communicate with clients. If you do not have internet access, it will be challenging to be a patient in our practice.
7. Partnership between patient and providers is the heart of our practice.
We strive to deliver quality health care to all of our patients. We ask that you take an active role in your healthcare, and understand how important this partnership is. As such, you are expected to:
Schedule and follow through on recommended lab tests
Refill supplements as necessary
Follow detailed health protocols designed by your provider
Contact your health insurance about unpaid claims when necessary
Pay invoices in a timely manner for all services provided
8. We know that achieving optimal health can be a challenge financially for some clients.
Health insurance will cover some of the services we offer, but it is very likely that you will need products and services not covered by your insurance plan to address complicated health concerns. Before you join our practice, please be sure you understand what is covered by your insurance.
You may need to budget funds for labs that insurance doesn’t cover or for the cost of recommended supplements. Every situation is unique, so that costs will vary.
Your insurance might require either a copayment or coinsurance for each visit. We cannot know the details of all plans, so please be sure to contact your insurance company to know what it will cover.
We can work with smaller budgets on labs and/or supplements if you discuss your needs with us.
We know that achieving optimal health can be financially challenging, and we will do our best to provide you with options that fit your budget, while at the same time keeping our practice viable. It’s best to contact your insurance company to determine what will be covered prior to your visit, to avoid any unpleasant surprises.
9. We are unable to offer in-house financing or payment plans.
If you cannot pay for services with cash/money order, you may use a credit card and make payments directly to the card.
Thank you for choosing us for your health care needs. We look forward to continuing to help you reach optimal health through a nurturing, supportive partnership.
