Insurance, Billing, and Payments
Insurance and Billing
We are an insurance free practice and a low volume office, offering our patients comprehensive care, expecting payment at time of service unless other arrangements have been made ahead of time, and providing you with the appropriate forms for reimbursement from your insurance company. Pappas Health is not enrolled as a “network health care provider/facility” with any insurance carrier. If you have a PPO plan that allows you to go “outside” of their network of approved health care providers, a portion of your assessment may be eligible for reimbursement. We will give you a superbill to submit to your insurance, after your appointment. To simplify the process, we recommend calling your insurance company prior to your visit to find out about what your specific plan will cover. Any eligible reimbursement will go directly to you.
We have chosen this path because we believe this is the best way to liberate the doctor patient relationship without the intrusive decisions forced upon us by insurers. We can thus together in partnership make a decision that’s right for you. Most medical plans anticipate a 20 to 30 minute physical and a 10 minute office visit/follow up which they reimburse accordingly. As we spend much time working to optimize your health we have declined to enroll as an “in-network provider” which would force us to minimize our time together. We provide lengthy visits and can often accomplish more in one visit than “in-network” providers do in several. Medical insurance is intended to cover emergency health problems, and to treat (not reverse) medical problems. If you want to optimize your health and prevent problems before they occur, likely you need to cover some of this expense. Please remember, optimal health is your single most important asset; don’t neglect it.
If you have an HMO plan or a plan that requires you to be seen “in-network” it is very unlikely that your assessment with us would be covered by your insurance plan. Of course you are encouraged to schedule an appointment with us to optimize your health in ways that a traditional medical insurance plan will not.
We are not Medicare providers; however we are able to order any tests needed for Medicare patients and these should be covered. Pappas Health does not participate in Medicare, and all patients with Medicare on any federally funded insurance program will need to sign a private contract.
In factoring in costs, please keep in mind that the most expensive part of the visit are the laboratory tests which are customarily covered by your insurance if drawn at a major laboratory and if we order them. It is important to note that the patient is responsible to check with the insurance plan to find out which lab company is preferred and if any labs will not be covered.
We require payment on the day of service. We accept Visa, MasterCard, Discover, and personal checks. A fee will be issued in the event of insufficient funds.