The Question of Insurance Coverage

Complementary and Alternative Medicine (CAM) is becoming more main stream every year and with that, more insurance companies start to cover services provided at 2bwell Clinic.

I can clearly remember the time that I started practicing and my patients had hardly any coverage through their medical insurance for my services. I am glad to announce that all our therapeutic personnel at 2bwell are now providers on most insurance panels for CAM. This has been a long and hard process both for the clinic and also our loyal patients since we started in our new location, January of 2006. However, the results are exciting and overcome all the hard work of creating a professional Wellness Center with high standards that is not exclusive to cash paying patients. Our goal is to spread the seeds of Natural Wellness and help as many patients as possible with the variety of services that we offer at 2bwell. And as some of you already know this first hand, having an insurance coverage that includes CAM sometimes makes the final decision for our patients to choose between conventional medical practices or try other alternatives. Like any thing else in life, having to deal with insurance companies have pros and cons both as a provider and a patient's view point. We had to have a complete separate branch and dedicated personnel to exclusively deal with insurance companies. Some of you may have already talked with Katie Denfeld who has been working with me for number of years even before starting 2bwell. You can see her picture and read about her background on our web site; Katie is dedicated to get the most accurate information about your coverage prior to the start of your care and then help to get appropriate coverage during the time of your care at 2bwell. She has many years of hands on experience at her job and has been a great asset for our clinic ever since we started, but her job is not easy. She usually spends a great part of her day waiting on hold or dealing with the bureaucracy of corporate world. We usually have to wait several days before we know your precise coverage and then several weeks or sometime months before we receive the first reimbursement check and she has to follow up and keep track of all that. In many occasions we need to obtain pre-authorization and explain our treatment out come in detailed with written correspondence to your insurance company before we are reimbursed. And all this effort by Katie and our practitioners and staff at 2bwell is primarily to help you receive the level of medical care and attention you need and reimbursement by your insurance company that you deserve. Billing your insurance company for our fees is an extra service that our clinic provides to ease the process of reimbursement. Except for insurance companies whom we are a part of their preferred providers, we don't have to bill your health insurance on your behalf. Billing your insurance company for our services means that we are carrying your balance on our own until we receive a payment from them which may take up to a year or even more from the original date of service. Because of all the extra overhead and specially time that it takes to collect your bills from your insurance company, we honor a courtesy discount for payments at the time of service if we absolutely don't have to do anything with the patient's insurance company or any other third party to collect our bills. That means you receive a discount from our typical charges and depending on the type of procedure, you may be charged a different amount on different days just like your insurance company but lower than what we would normally bill a third party for our services. This option works well for patients who either don't have any heath insurance or policies with very high deductibles. Otherwise it would NOT be in your advantage if you have an active health insurance since your co-pay or co-insurance is always much less than our discounted fees. Over the past 12 years I have done a lot of research about the advantages and disadvantages of insurance billing both from the patient and practitioner's point of view. I strongly recommend against patients doing their own insurance billing since it usually works in patient's disadvantage because they are not familiar with proper coding and follow-ups and they don't get paid for what they deserve.

I know all this may be very confusing from your perspective as a patient but we feel that it's necessarily for you to know about our billing practices and be able to receive explanation for some of your possible questions. Again, the main point to offer this service is to help you and provide the best possible assistance to ease the entire process of dealing with insurance companies. You can visit our web site to see a more comprehensive list of companies that may cover your care at our clinic and keep in mind that every policy is written differently and you need to confirm your individual coverage with your insurance company to get more specific information. Please feel free to contact Katie, Jamie, or me personally if you have any questions about your coverage and E.O.B (explanation of benefit) documents.

2bwell's Director and CEO
Siamak F. Shirazi, LAc, Ph.D.