We have partnered with Reimbursify for you to easily submit your claims for out-of-network health insurance reimbursement. We encourage you to download the Remibursify mobile app from the App Store or Google Play so that you save time and money associated with visiting our practice. You can also submit a claim now by clicking the link below.
What You Need to Know About
Your Health Care Insurance Coverage
We are privileged to have you as our patient, and if you are a new patient, please allow us this opportunity to welcome you to our practice.
Today there are hundreds of healthcare insurance companies, and each has dozens of plans. Each plan has its own restrictions and its own rules and payment policies for physicians, both of which are constantly changing. In addition, employer and individual plans may vary depending upon the benefit package purchased, so there is even variation between insured members that may even be on the same plan.
I practice an integrated approach to headache medicine, and commercial insurance plans do not recognize, or pay for, all that is involved in providing comprehensive traditional and complementary medicine. As such, I am unable to provide the level of care that I do if I participate with insurance plans.
That said, if you have out-of-network benefits, you will be able to submit my charges to your plan for adjudication and reimbursement for your out-of-pocket expense. Factors like deductibles and cost-sharing may apply. For information on your specific benefits – such as what is covered, what is not, and why – please refer to the benefits guide provided by your employer or your plan at the time of enrollment, or call the member number located on your insurance card.
Many plans require that you meet a deductible amount (whether in-network or out-of-network). This means that a certain amount of the claim payment will be withheld in order to meet the deductible amount, within a given time period. For example, you may have a $2,000 deductible, in which case your insurer will only start paying claims once you have reached $2,000 in services paid out of your own pocket.
Some plans also have a coinsurance provision, which means that the member/patient shares in a portion of the total payment for services rendered – in addition to a deductible - by paying a percentage of the total allowable (fee) due to the practice. Your insurer will process your claim, determine if there a cost-share amount, and reimburse you for any amount due to you from there.
For the most part, you can expect that whether you have in-network benefits or out-of-network benefits, you will need to satisfy your deductible before any benefits or reimbursement from your insurance company is extended. Patients that have out-of-network benefits can expect to be reimbursed for some or most of your out of pocket expenses once your deductible is met.