INSURANCE

Do You Accept Insurance?

Quite often we are asked if we "accept insurance?"


This is actually the incorrect wording as we "accept insurance," however the truth is that your insurance won't pay for what we do.


The correct question is "Will my insurance cover your services?" and that is actually a question for you insurance provider and not our facility.


But before you make the call, you need to be educated as to what you are asking.

The term they are going to use is called "Medical Necessity."  When you call, you will need to ask if they consider the services listed in our website tabs "medically necessary."


We can pretty much guarantee the answer will be "no" for the following reasons.

Here are all of the requirements that will need to be met for coverage.


DEFINITION OF MEDICAL NECESSITY:

 

"Medically Necessary" or "Medical Necessity" refers to health care services that a health care provider, exercising prudent clinical judgment, would provide to a patient. The service must be:

  1. For the purpose of evaluating, diagnosing, or treating an illness, injury, disease, or its symptoms
  2. In accordance with the generally accepted standards of medical practice
  3. Clinically appropriate, in terms of type, frequency, extent, site, and duration, and considered effective for the patient's illness, injury, or disease
  4. Not primarily for the convenience of the patient, health care provider, or other physicians or health care providers
  5. Not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of that patient's illness, injury, or disease


For these purposes, "generally accepted standards of medical practice" means:

  1. Standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community
  2. Physician and Health Care Provider Specialty Society recommendations
  3. The views of physicians and health care providers practicing in relevant clinical areas
  4. Any other relevant factors


Since we do not practice "medicine," nor diagnose or treat, and are primarily performing the services  for the convenience of the patient to know the true cause, as a general rule, insurance will not cover our services.


We agree with you that our services should be covered and we do not like this any more than you do.  But, we are not in any position to argue with the rules of your insurance carrier.


What we can do is keep our fees as low as possible, and work with privates labs and diagnostic centers for discounts up to as much as 75%.  All of this will be discussed during your Initial Health Evaluation.


On a final note, you may want to consider switching to a non-traditional insurance plan that would cover such services. 


Here are some websites for you to research, we are sure they are many more. We have no affiliation with any of these companies and they are not listed in any particular order.

https://altruahealthshare.org/ 

https://biblereasons.com/christian-healthcare-ministries/ 

https://sidecarhealthinsurance.com/ 

https://www.healthshare.hsaforamerica.com/healthshare-programs/ 

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