We often get asked by folks inquiring about our practice if we bill insurance or if we “take” a specific insurance. We thought it may be good to post about insurance here.
Most medical providers or practitioners see a great many more patients than functional medicine providers see in an average day. As functional providers, we typically only schedule 10-12 patients per day. We do not over book or double book; your time is your time. We plan for an hour for new patient visits and minimally, half an hour for follow up appointments. Some follow up appointments require extended time if is the first follow up after a new patient visit, or if you have three or more tests to discuss with Emily or Kayla. We do not want any of our patients to feel rushed, or as though we are “herding them in like cattle or sheep”. Most typical medical providers are seeing minimally 30 patients per day, and often times, a great many more than that.
When we have tried to bill insurance in the past, we have found that we generally received only about 30-40% of the billed amount back in payment from insurance companies. So, lets say for instance, your new patient visit is $300; if we billed that to your insurance company, we would likely get a payment from your insurance company between $90- $120. Now, let’s say your follow up visit of $150 was billed to your insurance company; we would most likely get somewhere between $45-$60 as payment from your insurance company. Let’s just be honest, we couldn’t keep our doors open for that amount in reimbursement.
There is a reason that many medical providers see so many patients in a day, and leave you, the patient, feeling as though your doctor rushed in and out of your room and did not leave you feeling as though you were heard or listened to. And let’s also talk about the appointments where you do not see your doctor; you see his nurse practitioner or his physician assistant. They are likely good practitioners also, but do you feel like they don’t know you as well as your doctor does? You’ve always seen your doctor, but all of the sudden, you have someone new looking at your chart for the first time, that really knows nothing personal about you. This is because having a nurse practitioner or physician assistant take your appointment for the day, allows your doctor to see a new patient or complicated case, and ultimately, allows the practice as a whole, to see more patients in a day, and, bill more to the insurance companies.
So, all of this to explain that here at Restorative Functional Medicine, we do not bill insurance for your appointments with either Emily or Kayla, simply because we take the time with you to hopefully make you feel as though you are listened to and are heard. Due to this we see far fewer patients in a day than a traditional medical clinics. That being said, we do have LabCorp in our office for your bloodwork labs, and they will bill your insurance for any bloodwork labs we send to them. We hope that does ease the burden of being a self-pay practice a bit. Another way we try to ease that burden of being self-pay is that we happily accept HSA or FSA cards as a form of payment for your appointments or diagnostic labs.
We are also often asked if we provide a superbill receipt for visits at our office for you to submit to your insurance company. The short answer to that question is , yes, we can provide you with a superbill for your visit. We will not however, call your insurance company for you, write any correspondence to your insurance company, or accept any payment/reimbursement that may be sent back to our office on your behalf. If we accept a check or reimbursement from any insurance company on your behalf, we have to agree to “accept assignment” from that insurance company moving forward, and bill that insurance company for any visits that you, or another patient with the same insurance as you, have.
We hope this helps explain our practice a bit more. We look forward to chatting with you and answering any other questions you may have about our practice or our appointment process, or getting you scheduled for your new patient appointment.