Our functional medicine clinic does not bill insurance. You may pay by check, credit card, or HSA debit card. Upon request, we can provide you with a copy of the superbill, which you can submit to your insurance company for possible reimbursement for out-of-network care. The superbill is a detailed medical receipt that contains procedure codes, diagnosis codes, and the fees charged for your office visit. We cannot guarantee what reimbursement, if any, you may receive. We do not submit claims or call insurance companies directly. This is the responsibility of the patient.

We do not participate with Medicare, nor do we bill Medicare for any services rendered. A patient can NOT submit superbills to Medicare for possible reimbursement.

Do you take insurance for lab work?

When paying cash for labs, how does billing work?

You can think about it this way. It's an exchange the doctor's cash pricing is transferred directly to the patient. So it's just an exchange of funds. LabCorp bills the doctor, and then the practice bills the patient, and that's how it works.

Are the labs usually ones that the insurance would cover?

You have two options A and B:

Option A: Submitting labs for insurance reimbursement

During the Foundational Assessment, we do blood work, and it depends on the patient's insurance coverage and diagnostic codes whether insurance will cover the lab work. We do an extensive foundational lab panel that looks at sex hormones, thyroid, inflammatory markers, cancer risks, cardiovascular risks, and vitamins and minerals. For patients who have a lot of diagnoses and have good coverage, we run it through their insurance. If you tell the doctor you want it run through your insurance, you can attempt to get it covered that way.

Option B: Paying cash for lab work

For patients who don’t have insurance that will cover their lab work, we’ve negotiated a cash price with LabCorp. Our entire initial panel can be between $150 and $300, depending on what the doctor needs to look into for your extensive foundational lab panel. Patients do need to understand that if you bill through insurance and they do not cover your lab work, it could cost you five to ten times as much, $2000 or more.

We leave it up to you to decide if you want to bill insurance or not. Most of our patients do the cash-priced labwork. It's also important to know that we do not mark up our lab work. When you pay cash for labs you get it at our discounted rate. It is very, very reasonable to get blood work done at cost.

When paying cash for labs, how does billing work?

You can think about it this way. It's an exchange in which the doctor's cash pricing is transferred directly to the patient. So it's just an exchange of funds. LabCorp bills the doctor, and then the practice bills the patient, and that's how it works.

As far as the advanced diagnostic testing, if there was a stool analysis or advanced hormone analysis, that all depends again on your insurance. We provide a super bill, which is a bill that you would provide your insurance company. You would pay the lab directly, and then the lab would give you a super bill. Then you would submit it to your insurance, and you would get reimbursed based on your plan.

Please feel free to call the office if you have any additional questions about billing.