Expect to be reimbursed at an out-of-network rate, after your deductible. At your visit, we provide you with an itemized receipt called a super-bill, for you to submit to your insurance carrier. Patients with PPO insurance report 70-80% reimbursement, and HMO reimbursement is less. We suggest calling your provider to determine your reimbursement prior to your appointment. On request, we can provide you with a list of codes to share with your insurer. Many receive even better reimbursement than predicted because we are credentialed with most insurers to decrease your out of pocket expense. We see many Medicare and Medicaid patients but unfortunately Medicare and Medicaid reimbursement is not possible at this time.
Why We Do Not Accept Insurance
- Many people who have contacted our office for services have asked us why we do not bill insurance directly when other medical and chiropractic providers do. We fully understand the financial challenge this presents to some patients, and we wish there were a way for us to bill your insurance company. Unfortunately, at this time, there is not.
- Insurance companies are more focused on the conventional model of health that too often relies on drugs and surgery as opposed to preventative and wellness services. When clinics bill health insurance companies directly, the doctors must sign a contract that allows the insurance company to determine which services they will and will not provide and how much they can charge for those services.
- A participating provider must agree to accept the fees the insurance company establishes, regardless of whether the fees are reasonable or applicable to that practice.
- Most doctors and clinics cope with the requirements and costs of being participating providers by keeping their office visits very brief, so that they can see many patients within a given time frame. Unfortunately, we have found that we cannot be “within network” and provide time-intensive, well-researched and expert care.
Medicare and Medicaid Are Not Able to Reimburse You
If you are a Medicare or Medicaid patient and are being treated for a Medicare or Medicaid covered service, all providers are obligated to bill Medicare/Medicaid according to their time frame and billing specifications. PIM is not able to comply because we do not have a conventional billing department. To respect the law, Medicare/Medicaid appointments at PIM address only non-Medicare/Medicaid covered services. As a Medicare/Medicaid patient, you cannot apply for or receive reimbursement from Medicare/Medicaid for your appointments. We are sorry, but this is the best we can do at this time given Medicare/Medicaid guidelines. We are confident that if you try PIM, you will be happy with your care and health outcomes.
Please note that we require a 3 business day notice for ALL appointment cancellations. If you do not provide this notice, you will be charged $300 as a cancellation fee for an initial appointment OR a $100 cancellation fee for a follow up appointment. There is a $25 cancellation fee for new patient initial appointments. If you provide 3 business day notice, your pre-payment will be applied to your rescheduled appointment or refunded to you. We charge a cancellation for the time spent PRIOR to your appointment reviewing your chart and history in orer to provide you with the highest level of care.