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FAQ

Why should I choose integrative medicine?

We believe Integrative medicine provides a more comprehensive approach.

Are these services covered by my insurance?

Effective 10/1/15, the Integrative Health and Hormone Clinic will be a direct pay practice. This means that full payment for your visit is due at the time of service. You pay for the quality of care you receive and insurance does not offer fair compensation to doctors that spend time with patients. Providers at the Integrative Health and Hormone Clinic are considered “out-of-network” with all insurance plans.

 

For information on your specific out of network benefits, please call the customer service number listed on the back of your insurance ID. Your insurance carrier may ask for a CPT code for the service being provided. At the end of your visit, you will be given documentation to submit to your insurance carrier for “out of network” reimbursement for office visits. The new patient codes are 99203-99205 and established or follow up codes are 99213-99215. The pellet procedure code is 11980.

 

Any insurance reimbursement received will depend on your plan and its specific benefits. Office visits purchased as a package and other nutritional counseling services provided are not eligible for submission to your insurance.

 

We deeply respect the fact that those 65 and over worked very hard for years and Medicare is part of the fruits of that labor. However, the Integrative Health and Hormone Clinic has opted out of the Medicare program and services provided by our office are not eligible for reimbursement.

 

If you have an HSA (Health Savings Account) they may or may not allow for reimbursement. Please check with your HSA representative to determine what they allow to be purchased with HSA money.

 

Your visit may include additional testing that is not billed through our office. In these instances you will need to contact the company who will be submitting the billing for additional billing codes, as our office does not have access to their specific billing information. Our fees are now posted on our website under Patients > Pricing Information. Please refer to this document for specific pricing and examples.

What role does my primary care provider (pcp) play in integrative medicine? Should I continue to see him/her?

We prefer your primary care provider is included in the plan of treatment. With your consent we will send your progress notes to your pcp. Yes! We recommend that you continue your care with your PCP as well as with all other providers. Our goal is to provide you with an integrative approach to assess your whole well being to adjunct the providers you are already working with.

Do I need a referral from my primary care provider?

Typically not for cash based services; however, we again recommend you check with your insurance carrier if you will be submitting claims to insurance yourself.