FAQs

IMG_20160116_223631Why don’t you take insurance?
Insurance requirements have become very complex requiring more time and staff to handle prior authorizations, incessant requests for chart notes, and other duties associated with having an insurance contract. The standard rates we must bill for a given diagnosis code or visit time is more than you need to pay, but less than can sustain a small clinic that wants to provide time for patient visits. Not taking insurance allows me to spend the time we both want for your visit, eliminate  higher costs of overhead, and thereby reduce the overall cost of health care in this clinic.

How can I get reimbursed by my insurance?
Insurance relies on codes for billing to decide what level of reimbursement they will provide. I will give you a receipt at your visit stating the amount you paid and the diagnosis code associated with that visit. I will not argue or provide chart notes to your insurance company for services rendered. If you want these extra services, there will be a fee for time involved. Many insurances will reimburse you because it is less than they would have to pay otherwise.

Alternatively, most  insurances now have an annual deductible that the patient must pay before the insurance will pay.  The billing slip and receipt I give you can be sent in to apply these payments to your deductibles.

My insurance denied my request for surgery/meds, what do I do?
Send a letter of appeal. Email me for a template you can edit to suit your needs. If you want a letter from me on letterhead, there is a fee of $25 each. Email me with this request.

Why aren’t you in clinic more often?
I am either at another clinic helping because they do not have enough doctors; attending CME (continuing medical education), or I am on vacation.

I need a letter/labs/information while you are out of the office, what do I do?
Email me and be patient (no pun intended)  Even when I am out of town, I usually have internet access at some point and will make the effort to check at least weekly. If you have not heard from me in 2 weeks, resend your request, I may not have received it. I will acknowledge all requests the day received, but it may take longer to actually complete your request. This means do not wait until the last moment to make requests.

How do I pay for fees incurred outside of my clinic visit, ie research time or letters?
You will receive an invoice via email if you consent to correspondence via email. This charge will be added to your next appointment and will be collected then. If you don’t have another appointment you can stop by the clinic or make arrangements over the phone.

I am being charged for labs and don’t understand why?
The lab is responsible for its own billing, you will need to talk with them. If there is a coding issue, please email me, you can attach a copy with the codes. Unfortunately most of these issues will be an insurance and lab issue, and not anything I can change on my end.

Why is the Internal Medicine rate different than the other appointments?
The Internal Medicine evaluation is more complex and takes more time and usually entails a review of a significant quantity of previous records.