Why don’t you accept insurance?
I have chosen not to accept insurance for my medical practice for several reasons, the primary being that I am able to spend adequate time with each individual that I see while maintaining my own well being. I realize my services are quite expensive for some patients though, and I am trying to mitigate this with several options including offering patients a Superbill following each visit.
At present I cannot see patients who are under Medicare coverage, as I am not opted into Medicare as a provider.
What is a Superbill?
A Superbill is an itemized receipt with specific information about the appointment that can be submitted to your insurance provider with me being an “out-of-network” medical provider. The amount you’ll be reimbursed will depend on the insurance plan you and your family have. Some insurance companies may not offer any reimbursement.
My current cost breakdown is as follows:
New Patient Appt (80 min) - $450
Follow Up Appt (40 min) - $275
Infant/Child Follow Up (40 min) - $225
House Call – $600-800, plus travel fee outside of San Francisco
How do I submit a Superbill to my insurance provider?
Every insurance company’s policies are different and it is best to contact them directly before attempting to submit your Superbill. You should be able to contact them via the number for “Members” or “Member Services”.
1. Verify out-of-network benefits
2. Verify their process for submitting a Superbill
3. Confirm your home address with your insurance company (especially if they reimburse you with a check)
You’ll want to ask if pre-authorization is required, and if so have on hand your name, date of birth, member number, and my name and practice address. The representative may give you a number of visits that the insurance company is willing to cover in a certain time frame. Your insurance may only offer Superbill reimbursement to you for a limited number of visits.
Once clarified the above points, you can submit your Superbill to your insurance company in one of these ways:
1. Fax to Insurance Company
2. Mail to Insurance Company
3. Upload to the Insurance Company Portal
You can ask the Members Services representative in your initial call which options are available to you. I will provide you with a PDF of the Superbill or can print it for you. I cannot fax or mail it on your behalf.
Other items of note:
HSAs and FSAs may be eligible for this kind of care as well. Contact your representative to find out if this option can be utilized.
I currently accept all major credit cards, cash and Venmo payments.