This page provides answers to some common questions about insurance coverage and our payment policies.
Q: Do you take insurance?
A: No. I’m out of network with all health plans.
Q: Why don’t you take insurance?
A: It’s too complicated and expensive for a solo practitioner.
Q: Will my insurance pay for visits with you?
A: Possibly. Many patients have out-of-network benefits. Please call your insurance company to explore your benefit plan. Ask them to explain your coverage for out-of-network providers.
Q: How does billing work?
A: We mail patients a statement (bill) after each visit. Patients then pay me with a credit card, debit card, bank transfer or personal check.
Q: Do I get paid back by my insurance company?
A: Sort of. Payments to me get applied to your annual deductible (minus your personal responsibility or “copay”). You become eligible for reimbursement when you reach your annual deductible.
Q: What does my insurance company need?
A: You’ll need to file an out-of-network claim. Please contact your insurance company and follow their usual process. They’ll probably want a superbill and possibly proof of payment. You automatically receive a receipt by e-mail when you pay online. We can mail you proof of payment if you pay me with a personal check.
Q: What’s a superbill?
A: Superbills contain all of the information that insurance companies require to process an insurance claim: CPT code(s), ICD-10 code(s), my NPI number, my federal tax ID number, et cetera.
Q: What if I don’t have out-of-network benefits?
A: You can still see me, however, your insurance company won’t cover any of the visit. Or, you can attempt to get coverage by submitting a prior authorization. Insurance companies sometimes approve these requests if there aren’t good in-network options (which is often the case for Suboxone).
Q: Can I use my Health Savings Account (HSA) to pay you?
A: Probably. Please call your insurance company to verify that visits with me are a qualified medical expense.
Q: How much do you charge?
A: It depends on your insurance. I have one rate for patients with private insurance and another for those with Medicare. Here’s a partial fee schedule for the former. Medicare’s rates, which are set annually by Congress, are publicly available here.
Q: Do you see patients with Medical Assistance?
A: Generally not. Minnesota’s Medicaid (Medical Assistance) program requires patients to obtain prior authorization for visits with me. Most patients are unwilling to jump through the required hoops. I’m happy to see those who pursue prior authorization after they receive approval from their managed care organization.
Q: What if I have more questions?
A: Please contact my assistant, Kris, if you have questions.