An Explanation of Our Financial Policy
At Bespoke Wellness LLC, we are passionate about what we do, and we feel that we have a calling to provide as many people as possible with the highest quality natural health care possible. Just as our services are unique to this region, our financial policies set us apart from mainstream medicine.
Why We Do Not Accept Insurance Assignment
Some of our patients have asked us why we do not bill insurance directly. While we fully understand the financial challenge this presents to some patients we have chosen not to bill insurance directly for the following reasons:
When clinics bill insurance companies directly, the doctors are required to become participating providers. The doctors must sign a contract that allows the insurance company to determine which services they will and will not provide, and how much they can charge for those services. In general, insurance companies are not focused on any preventative or wellness services. They are heavily invested in the conventional model of health care that too often relies on drugs and surgery. We are committed to the functional medicine model that addresses the underlying causes of your symptoms with specific nutritional and lifestyle recommendations.
A participating provider must agree to accept the fees the insurance company establishes, regardless of whether the fees are reasonable or applicable to that practice. In general, these established fees cover the actual cost of the briefest (and we believe the lowest quality) care. Doctors who are participating providers are required to accept discounted fees for their services. Therefore, the clinic must write off the difference, often as much as fifty percent or more of the doctorʼs fee for service. Our office cost to provide high quality care has increased dramatically over time, making this a very difficult situation. You may be aware but in todayʼs health care environment, the actual cost for doctors to provide services continues to rise, while the percentage of reasonable fees that insurance payments cover is declining.
Most doctors and clinics cope with the requirements of being participating providers by keeping their office visits very brief, so that they can see many patients within a given timeframe. When the clinic becomes unprofitable, it will need support from another institution. Most primary care medical clinics are not self-sustaining financially, and have had to merge with hospitals whose expensive high-tech surgical and diagnostic procedures are priced to keep the clinics afloat.
Ironically, some of our patients complain about their extremely brief office visits in other medical practices, while at the same time expressing frustration that we do not accept insurance. Unfortunately, we have found that we cannot stay in the insurance networks and provide the time-intensive, well-researched, expert care that you will get at Bespoke Wellness LLC.
Why We Charge For Follow-Up Consultations
Some patients have asked why we charge for follow-up consultations regarding lab results and exams, as well as for telephone consultations.
In follow-up visits, our doctors spend significant time discussing your results with you. For example, it is relatively simple to inform a patient that her mammogram is negative; but it is entirely different to discuss the results of more complex functional evaluations and to recommend practical lifestyle and dietary strategies that may help to prevent breast cancer. We want you to understand that preventative health care takes considerable time and expertise on the part of the doctor, and someone has to pay for that time and expertise.