Maryland Integrative Health Financial Policy
As a physician, I feel called to provide the highest quality natural health care possible. Just as our services are unique, our financial policies set us apart from mainstream medicine. We have prepared this handout to answer questions you or your family members may have about the rationale for our financial policies. If, after reading this, you still have questions, feel free to speak with our staff.
Why We Do Not Accept Insurance Assignment
Many people who have contacted our office for our services have asked us why we do not bill insurance directly when other medical providers do. We fully understand the financial challenge this presents to some patients, and we wish there were a way for us to bill your insurance company. Unfortunately, at this time, there is not. Here is why:
When clinics bill health 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 preventive 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 integrative and functional medicine model that addresses the underlying causes of your symptoms with specific nutritional and lifestyle recommendations.
A participating physician 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, and they cannot bill the patient for the difference between their fee and what the insurance company will pay. Therefore, the clinic must write off the difference, often as much as 50% or more of the doctor’s fee for service. At the same time, the participating provider’s office overhead costs have increased dramatically because of the staff, time, and equipment necessary for processing and tracking claims. You may use your Flex-spending or Healthcare Savings Account funds for our services.
In today’s healthcare environment, the actual cost for doctors to provide services continues to rise, while the percentage of reasonable fees that insurance payments cover is declining. At the same time, the profits of health insurance companies and the salaries of their top executives continue to rise to record levels.
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 time frame. When their clinic becomes unprofitable, it must be supported by another institution. Many 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 financially. Ironically, some of our patients complain about their extremely brief and unsatisfactory 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 be participating providers in the insurance networks and provide the time-intensive, well-researched, expert integrative care that we do.
Why Our Doctors Must Charge for Your Follow-up Consultations
Some patients have asked why we charge for follow-up consultations regarding lab results and exams, medication and supplement consults, as well as for telephone consultations, when other doctors do not. Our doctors are not salaried, as are doctors who are employed in large clinics and hospitals and whose salaries are partially subsidized by expensive diagnostic and surgical procedures and hospital fees. Our doctors’ pay is based solely on the time and services they provide. Like all non-salaried professionals, including lawyers and accountants, our doctors must charge for their time so we can afford to provide you with care and remain in business. In general, we charge only for our face-to-face time with you. Our doctors spend considerable non-reimbursed time each week consulting with other physicians (and other providers) regarding your care, reviewing your records, interpreting your lab studies and meeting with our team to improve the quality of our services.
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. Patients often complain that conventional doctors do little to nothing in the way of truly preventive medicine. We want you to understand that preventive health care takes considerable time and expertise on the part of the doctor and that someone has to pay for that time and expertise.
** If you are engaged in one of our Root Cause Programs all appointments in your program will be included. Additional consultations and coaching are available as needed for an additional fee.
Why We Sell Nutritional Supplements and How We Price Them
We recommend nutritional supplements as an adjunct to dietary and lifestyle modification. This approach is central to the well-researched and science-based practice of functional medicine, which all of our professional staff have studied. We recommend therapeutic, quality nutritional supplements as a service to our clients. We feel that ordering from Full Scripts, WholeScripts, MegaSpore, Organo or purchasing in the office controls the quality of the product purchased and we can be assured that the supplement has been properly stored, is not expired, and is not counterfeit.
For more information on our nutritional supplement policy, please read our “Informed Consent Regarding Nutritional and Herbal Supplements” document. All of our policies are available through the patient portal on our website.
Medicare and Medicaid Are Not Able to be Reimbursed
If you are a Medicare or Medicaid patient and are being treated for a Medicare or Medicaid covered service, all providers are obligated to bill Medicare/Medicaid according to their time frame and billing specifications. Maryland Integrative Health, LLC is not able to comply because we do not have a conventional billing department. To respect the law, Medicare/Medicaid appointments at Maryland Integrative Health, LLC address only non-Medicare/Medicaid covered services. As a Medicare/Medicaid patient, you cannot apply for or receive reimbursement from Medicare/Medicaid for your appointments. We are sorry, but this is the best we can do at this time given Medicare/Medicaid guidelines. We are confident that if you try Maryland Integrative Health, LLC you will be happy with your care and health outcomes.
Our Guarantees and Refunds Policy
We have 2 guarantees. First, we have a 100% results guarantee, which means that you are 100% guaranteed to succeed IF you do the work and get our support when needed. The only time you won’t succeed is if you give up when things get challenging.
Second, we have a 0% money back guarantee. This program is not a book or a course that you do on your own. We invest a HUGE amount of time, energy, and money to support you every step of the way and we know that our strategy works 100% of the time for those who do the work. That’s why you need to take 100% responsibility for your results.
Program Hold Policy
You have the option to place your program on hold for a period of up to 6 months, starting from the date of the request. During the hold period, you will temporarily suspend all scheduled appointments, sessions, and services associated with the program.
Please be aware that while your program is on hold, your payment schedule will continue as originally agreed upon. The hold period does not exempt you from fulfilling your financial obligations for the program. Once the hold period ends, your program services and appointments will be reinstated accordingly.
It is the intent of Dr. Tricia Thompson, DO to offer products and services through this Website which reflect the work of Tricia Thompson, DO / The Root Cause Doc TM and the medical practice of Maryland Integrative Health, LLC. However, neither Tricia Thompson, DO, nor Maryland Integrative Health, LLC nor any other person or organization, whether private or governmental, has endorsed, evaluated, reviewed or approved the content of this Website or the products and services offered through this Website.
THIS WEBSITE DOES NOT PROVIDE ANY MEDICAL ADVICE. Information on this Website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. You should not use the information on this Website for diagnosing or treating any health problem or disease, or prescribing any medication or other treatment. You should always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or adopting any treatment for any health problem. For any products or services purchased from this Website, you should read carefully all product packaging and instructions. If you have or suspect that you have a medical problem, promptly contact your health care provider. Never disregard professional medical advice or delay in seeking professional advice because of something you have read on this Website.
Information provided on this Website and the use of any products or services purchased from this Website by you DOES NOT create a doctor-patient relationship between you and Dr. Tricia Thompson, DO, The Root Cause Doc or you and Maryland Integrative Health, LLC nor any other physician or provider affiliated with this Website.
Information and statements on this Website regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.
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