Insurance and Fees

Fees for Services

Initial visits for osteopathic treatments and holistic health evaluations usually last 1½‑2 hours and include any or all of the following; a complete review of medical, family, surgical and social history, a physical exam, nutrition and lifestyle analysis, addressing acute and/or chronic issues, osteopathic treatment, and a discussion of follow-up and goals we will work towards. The fee for initial visits is $350.Follow-up visits for osteopathic treatments, lab results or discussion of plan last one hour. The fee for one-hour follow-up visits is $225.

Medicare fees are set by Medicare (see below).

When labs and radiology are ordered they are usually billed directly to your insurance company by the facility (laboratory, radiology group, etc.) handling the order, meaning you usually do not have to pay for them at the time they are rendered.

Insurance Information

PPO Insurance Plans

PPO type insurance plans generally cover at least some portion of our services. If you have a PPO, you will be responsible for payment in full at the time of the visit. We will then send a Superbill to you for submitting to your insurance company. The insurance company will in turn send you any reimbursement that is due to you.

We are not contracted with any PPO insurances, so we are considered “out of network”. As such, you will usually be reimbursed for a portion of visits and treatments, but not as much as if you went to an “in network” or “contracted” PPO doctor.

Experience has demonstrated that reimbursement from PPO’s runs anywhere from 80% on down. We encourage you to call your insurance company ahead of time to find out how much they will pay for visits to our office.

On our Forms page is a download titled “Out of Network Quote of Benefits” which you can use when you call them. With this information, they can help you determine your reimbursement for osteopathic treatments and some office visits. If you are interested in osteopathic treatments, please stress to your insurance company that you are having an osteopathic treatment, not chiropractic care or physical therapy.

Medicare

If you are fortunate enough to qualify for Medicare, most of the cost of our services will be covered. However, as with all patients, payment in full is due at the time of your visit.  We will submit your Medicare claim electronically for you. Medicare will then reimburse you for most of the cost.

The Medicare deductible is $150, which must be paid if you don’t have secondary insurance. First visits are $299.46, and follow-up visits run $190.51 to $231.62. These fees are set by Medicare. Your out-of-pocket expense after Medicare has paid you will likely be $84 for the first visit and $52-$64 for follow-up visits.

If you have a secondary insurance in addition to Medicare, your out-of-pocket expense after Medicare and your secondary have paid will likely be $36 for the first visit and $22-$28 for follow-up visits. Occasionally secondary insurance will have a deductible.

These figures are an approximation and provided to you as a courtesy. Medicare payments vary from year to year, and occasionally even within the year. We will update them as best we can. In addition, benefits provided by secondary insurance companies are not all the same.

Medi-Cal

If you have Medi-Cal, our services will not be covered as we are not contracted with Medi-Cal. As such, payment for services is due at the time of the visit, and you will not be reimbursed by your insurance company.

HMOs

If you are covered under an HMO plan, our services will not be covered as we are not contracted with any HMOs. As such, payment for services is due at the time of the visit, and you will not be reimbursed by your insurance company.

Forms of Payment

We accept only Visa, Mastercard, check or cash. Payment is due at time of services.