EFFECTIVE APRIL 1ST, 2016 WE WILL NO LONGER BILL INSURANCE DUE TO THE LOW RATE OF REIMBURSEMENTS FOR WEIGHT LOSS.
WE WILL BE HAPPY TO PROVIDE YOU WITH A RECEIPT OR A SUPERBILL FOR YOU TO SUBMIT TO YOUR CARRIER FOR OUT OF NETWORK BENEFITS.
As a courtesy to our patients we are happy to check your insurance to see if they accept Out Of Network (OON) insurance billing. If they do accept OON billing we will be happy to submit a claim to your insurance company for your first appointment at our clinics if your annual deductible is below $1500 or your deductible has been met for the year.
Insurance that will not pay OON benefits:
If you have an HMO Plan they will not pay any OON benefits.
If you have Medicare/Medicaid they will not pay any OON benefits and will not pay for weight loss specifically. There are several other insurance carriers that will not accept OON insurance billing and our staff will be happy to let you know if your insurance is one that will not pay.
If Your Insurance Pays For Your First Visit:
You will pay for your visit up front out of pocket and we will reimburse you after we have received payment from your insurance company provided they pay the minimum amount accepted. After your first visit we will try to have you seen by our medical practitioner once a month and bill your insurance for one visit a month. We do not require you to pay us your deductible or your co-insurance amount. If your insurance pays us our minimum amount accepted, currently $275 for the first visit, you will be reimbursed your out of pocket costs for your first visit and will not owe us your deductible or co-pay. If your insurance pays us less than our minimum amount accepted there will be no reimbursement to you.
How Long Do I have to Wait For My Reimbursement:
Insurance companies take approximately 30-90+ days to pay on an insurance claim and as soon as we receive the funds we will issue you a credit or send you a check for the amount paid by you on your first visit if the amount paid is over our minimum amount accepted. Some companies like Blue Cross Blue Shield can take as long as 6 months to reimburse on a claim made.
Other Options FSA & HSA:
If your insurance will not pay OON benefits and you have a Flexible Spending Account (FSA) or a Health Savings Account (HSA) you may obtain a receipt from our offices to be reimbursed the cost of our services pre-tax from one of these accounts provided your insurance FSA or HSA will reimburse for weight loss. You will need to check with your FSA or HSA account to find out if they will reimburse for Weight Loss Services. We are happy to provide you with a medically necessary letter for any insurance, FSA or HSA, that requires one.
Meeting Your Deductible:
If your deductible is over $1500 and you have not met any of it for the year and you want us to bill your insurance company we will charge you $25 to have us complete the billing. Some patients like to have the first visit cost applied to their deductible just incase something else happens that year and they would like more of their deductible met for the year. If we do this for you we will not expect you to pay us your deductible or any co-pays, we are happy to provide this service to you for the $25 fee knowing that your insurance will not reimburse any of the costs billed as your deductible is to high.
Please call our offices for more details on our insurance billing options.
To reach our AZ Clinics call 602-374-7226 (3 Clinics in Mesa, Phoenix, and Scottsdale)
To reach our NM Clinics call 505-888-9575 (3 Clinics in Albuquerque, Rio Rancho and Santa Fe)