Insurance Billing
Sorry if I'm the first one breaking this to you, but insurance is a mess.
At this time I am contracted with several insurance carriers, but the actual coverage depends on many factors.
Unfortunately, as I am "In Network" with many insurance companies, patients tend to take that as a promise that if they are members of those insurance companies, then all their care will be covered.
The sad reality is that is rarely the case.
Between deductibles (that patients are often not aware of), insurances randomly denying Naturopathic coverage (illegal in the state of Oregon but done anyway) to the fact that the specialized care I often recommend and prescribe are not covered by insurance (Regenerative Injection Therapies are one biggie here), I cannot be closely involved in the conversation of what is and isn't covered.
Your insurance coverage is a contract between you and your insurance company.
Your lack of coverage and surprise bills of non-covered services are also between you and them. With each passing year in practice, it is getting more and more difficult to navigate care where an outside entity irrationally deems care or prescriptions or labs covered one week and not the next.
If you have never discussed your insurance coverage with your insurance company before, please have that conversation with your insurance company prior to using your insurance for any healthcare needs.
My office "verifies insurance coverage," but this is just preliminary information to know whether they should collect a co-pay, and for how much. Or whether a deductible is remaining and whether they should collect that.
This is information they collect as a courtesy and not a promise of coverage. If you call your insurance company (which I highly, highly recommend you do!) even their recorded message says that any information they give is not a promise of coverage. And they're the entity providing the insurance coverage! So if they won't even stick to what they say, my office of course cannot make any grandiose guarantees.
At this time I am contracted with several insurance carriers, but the actual coverage depends on many factors.
Unfortunately, as I am "In Network" with many insurance companies, patients tend to take that as a promise that if they are members of those insurance companies, then all their care will be covered.
The sad reality is that is rarely the case.
Between deductibles (that patients are often not aware of), insurances randomly denying Naturopathic coverage (illegal in the state of Oregon but done anyway) to the fact that the specialized care I often recommend and prescribe are not covered by insurance (Regenerative Injection Therapies are one biggie here), I cannot be closely involved in the conversation of what is and isn't covered.
Your insurance coverage is a contract between you and your insurance company.
Your lack of coverage and surprise bills of non-covered services are also between you and them. With each passing year in practice, it is getting more and more difficult to navigate care where an outside entity irrationally deems care or prescriptions or labs covered one week and not the next.
If you have never discussed your insurance coverage with your insurance company before, please have that conversation with your insurance company prior to using your insurance for any healthcare needs.
My office "verifies insurance coverage," but this is just preliminary information to know whether they should collect a co-pay, and for how much. Or whether a deductible is remaining and whether they should collect that.
This is information they collect as a courtesy and not a promise of coverage. If you call your insurance company (which I highly, highly recommend you do!) even their recorded message says that any information they give is not a promise of coverage. And they're the entity providing the insurance coverage! So if they won't even stick to what they say, my office of course cannot make any grandiose guarantees.
Self-pay (no insurance) details
Here's the general info I can give- but please call to get more specifics:
---If you are using insurance of any kind to pay for your office fees, the portion you're responsible for varies widely, depending on the types of services. We apply an average of a 25% discount to all office fees when payment is made at the time the service was received. That applies to all who are self-paying to the clinic at time of service. This may be because of either no (Naturopathic) insurance coverage, paying out of pocket due to high deductible, or using a health savings account.
---The complexity of appointments vary (and to a certain extent, so does the time given to address your concerns); our office fees reflect that. So a short visit on a relatively simple topic with a return patient will cost less, maybe even half of a new patient visit for one or more urgent, long-standing chronic health issues. Call us if you would like more details.
---If you are using insurance of any kind to pay for your office fees, the portion you're responsible for varies widely, depending on the types of services. We apply an average of a 25% discount to all office fees when payment is made at the time the service was received. That applies to all who are self-paying to the clinic at time of service. This may be because of either no (Naturopathic) insurance coverage, paying out of pocket due to high deductible, or using a health savings account.
---The complexity of appointments vary (and to a certain extent, so does the time given to address your concerns); our office fees reflect that. So a short visit on a relatively simple topic with a return patient will cost less, maybe even half of a new patient visit for one or more urgent, long-standing chronic health issues. Call us if you would like more details.
Primary Care
I function as a healthcare specialist. I provide expert care in reversing hormone dysfunction and using regenerative medicine to put joints back together.
Please keep your Primary Care Physician who does your annual exams and provides other screening and preventive care. Please get a PCP ASAP if you do not already have one. Your insurance company can provide you with a list if needed.
Due to my schedule, and also because more insurance companies have been putting up unreasonable barriers regarding NDs functioning as PCPs (who wants a surprise bill for a pap? Not me!), it is best to keep your PCP and see me as the specialist that I am.
Please keep your Primary Care Physician who does your annual exams and provides other screening and preventive care. Please get a PCP ASAP if you do not already have one. Your insurance company can provide you with a list if needed.
Due to my schedule, and also because more insurance companies have been putting up unreasonable barriers regarding NDs functioning as PCPs (who wants a surprise bill for a pap? Not me!), it is best to keep your PCP and see me as the specialist that I am.