Finances

Overview

The first question that everyone asks is "will you take insurance?" As a solo practitioner with a very small patient panel, it's cost-prohibitive for me to contract with insurance companies so I will not be able to bill insurance. However, I will provide a superbill that you can submit to your insurance for out-of-network reimbursement and/or to apply my fee to your insurance deductible (if available). I'm happy to explain this process if you have any questions.

Additionally, I have intentionally set my prices at a rate that I hope is a low barrier, much lower than the typical price for private pay and non-Medicare health insurance. I am basing my fees based on the allowed rates for Medicare in Seattle; these are typically about $200 less than allowed rates for regular health insurance. (If you have a high deductible that you don't meet annually, this should be significantly less expensive than continuing with Optum.)

Payment

Credit card (including FSA/HSA) card must be on file at time of appointment and will be charged when I complete all the documentation and any tasks associated with our appointment (usually later the same day).

A superbill will be emailed to you when your card is charged.

Medicare

I am not enrolling with Medicare. I am happy to see Medicare patients but they will not be able to submit for reimbursement for their appointments or other fees. FSA/HSA funds may be used. My research indicates that medications prescribed by me will be covered by Medicare part D, however this is not guaranteed.

Standard Fees

For returning patients, there will be two appointment prices:

$100 - This will be the price for most appointments. At this appointment, everything that needs to be completed for your care will take place during the appointment. This includes medication refills and dose increases and standard counseling visit. Appointment time should be about 20 minutes (not including the extra chit-chat about dogs and kids and vacations . . . ).

$145 - This will be the price for appointments that include more medical management, including medication changes, lab reviews and new lab orders, initial prior authorizations, and other things that will require more of my time outside our appointment.

The above fee levels are based on standard insurance coding and consider appointment time and complexity. It will not always possible to know in advance which level of service will apply. These fees will be included on your superbill and may be submitted to your insurance company for reimbursement or application to your deductible.

Additional Fees

Additional fees may be charged for tasks not associated with an appointment. Examples of this might include:

Insurance appeals for medication prior authorization
Extensive medical advice through portal messages
Prior authorization renewals
Communication with other medical providers

These fees will be assessed based on actual time spent on these tasks at the rate of $25 per 15 minutes. I will provide an estimate of expected time prior to beginning a task.

With the exception of portal messages, these fees will not trigger a superbill and will not be reimbursable by insurance or able to be applied to your deductible. They will qualify for payment with FSA/HSA funds.