As a physician, I am passionate about what I do. I decided I no longer wanted to practice medicine the way the traditional medical system has required it to be practiced. Instead, my focus is on the patient and personalizing their care. The current system rewards more medications, procedures, and interventions instead of counseling on the modifiable risk factors that have great impact, but less financial gain for the medical system. It is easier for a physician to give out a prescription that to actively deal with their root cause of their medical issue. This is not how I want to practice medicine. Just as my services are unique, my financial policies set me apart from traditional mainstream medicine.
When clinics bill health insurance companies directly, the doctor is required to become a participating provider. The doctor 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. I am committed to the integrative medicine model that addresses the underlying causes of your symptoms with specific nutritional and lifestyle recommendations. Health insurance companies put parameters on how patients are treated and whether patients can have certain tests or procedures. 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 today’s healthcare environment, the actual cost for doctors 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 doctors 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. Unfortunately, I have found that I cannot be a participating provider in the insurance networks and provide the time-intensive, well-researched, integrative care that I do, especially since based on the number of patients I have had to see under the traditional care model.
I am an out-of-network provider, and thus I do not contract with any medical insurance company including Medicare. You can call your insurance company and see if they offer any coverage for an out-of-network provider. If so, they may reimburse you a percentage of our encounter visit. We will be happy to provide you with an encounter form that will detail the diagnosis code and level of service or procedure performed, so you can submit it to your insurance company. You can also use FSA/HSA funds to pay for the encounter.