Many people who have contacted our office for our services have asked us why we do not bill insurance directly when other medical providers do. As healthcare providers and staff, we are passionate about what we do, and we feel that we have a calling to provide as many people as possible with the highest quality integrative health care possible. We fully understand the financial challenge this presents to some clients and we wish there were a way for us to bill your insurance company. Unfortunately, at this time, there is not. Here is why:

• Insurance companies do not recognize a lot of aspects of integrative health and do not deem them medically necessary.  We choose to use the time we would spend arguing with insurance companies with our clients instead. Studies have shown that patients spend less overall in a cash-based practice vs. an insurance-based practice because they are on a wellness journey which is proactive, not reactive.    
• We offer clients receipts they can submit for reimbursement to their insurance companies.  Clients can use their Health Savings Accounts (HSA) to pay for their treatment if it is allowed by their plan.          
• When clinics bill health insurance companies directly, the clinicians are required to become participating providers. The clinicians 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. In general, insurance companies are not focused on any preventive or wellness services. They are heavily invested in the conventional model of health care that too often relies on drugs and surgery. We are committed to the functional medicine model that addresses the underlying causes of your symptoms with specific nutritional and lifestyle recommendations.

• 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. In general, these established fees cover the actual cost of the briefest (and we believe the lowest quality) care. Healthcare providers who are participating providers are required to accept discounted fees for their services, and they cannot bill the client for the difference between their fee and what the insurance company will pay. Therefore, the clinic must write off the difference, often as much as 50% or more of the clinician’s fee for service. At the same time, the participating provider’s office overhead costs have increased dramatically because of the staff, time, and equipment necessary for processing and tracking claims. 
• In today’s healthcare environment, the actual cost for healthcare providers to provide services continues to rise, while the percentage of reasonable fees that insurance payments cover is declining. At the same time, the profits of health insurance companies and the salaries of their top executives continue to rise to record levels.
• Most healthcare providers and clinics cope with the requirements of being participating providers by keeping their office visits very brief, so that they can see many patients within a given time frame. When their clinic becomes unprofitable, it must be supported by another institution. Most primary care medical clinics are not self-sustaining financially and have had to merge with hospitals whose expensive, high-tech surgical and diagnostic procedures are priced to keep the clinics afloat financially. Most clinics keep office visits very brief and see many people per hour. Ironically, some of our patients complain about their extremely brief and unsatisfactory office visits in other medical practices, while at the same time expressing frustration that we do not accept insurance. Unfortunately, we have found that we cannot be participating providers in the insurance networks and provide the time-intensive, well- researched, expert intensive care that we do.