About Insurance Carriers
Most private and public insurance carriers will cover hospital care, surgery, acute care, office visits and labs. Even then, depending on your plans deductible, lab and prescription coverage, co-insurance and preventive care options, you may be left with hundreds/thousands of out of pocket costs. We have seen this time and again as health costs continue to soar. With this also comes the 'dialing for dollars' situation most practices are facing in seeking insurance reimbursement. Many practices are now part of larger hospital systems in order to deal with the complexities of the insurance/coding system. It is important to find a primary care provider who is part of the system. You can use your insurance/Medicare for many of the basic screening tests.
In 2011, we chose to be 'Out-of-Network' providers. We discount our fees an​d overall bill less than the 'usual and customary' charges for the time spent and complexity/ number of problem(s) addressed. Your insurance can reimburse you according to your plan's guidelines. Many Functional Medicine Providers will opt out of insurance and give you codes to get reimbursed. This is because insurance carriers will not pay for the time involved in truly getting to know you and using all modalities other than prescriptions, referrals, surgery etc. All are needed depending on the situation. It takes time and effort to prioritize and help you.
​
​
