PAYMENT

You’ve Got Questions - I’ve Got Answers

WILL MY INSURANCE COVER MY VISIT?

I participate as an in-network provider with many health insurance plans. 

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As of  September 1, 2021, I am no longer in-network with Anthem Blue Cross.  

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If I do not participate in your health insurance plan but your plan has out-of-network benefits, you will likely be able to receive reimbursement for a portion of your cost of treatment with me and I can provide an invoice with the information needed to do so.  Even if your plan does not have out-of-network benefits, your plan may pay for my services if there are no available physicians in their network who can see you within a reasonable timeframe or I provide a service that you are unable to receive elsewhere.  I have created this Insurance Worksheet to assist you with advocating for the benefits you are due.

I do not participate in Medicaid (MaineCare) or Medicare (including Medicare Advantage Plans).  As these plans do not offer out-of-network benefits, they will not provide you reimbursement.  A special exception applies for MaineCare members through the Private Health Insurance Premium (PHIP) benefit program. If you qualify, PHIP pays what it costs you to get insurance.  It may also pay any additional costs, such as deductibles.

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WHAT METHODS OF PAYMENT DO YOU ACCEPT?

Payment is due at time of service.  We accept cash, check, credit cards, debit cards (including health savings accounts), venmo, and paypal.

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NO SURPRISES ACT

If you do not submit claims to your insurance company, either because you are uninsured or choose to self-pay and not seek any reimbursement, the No Surprises Act applies. It also applies to patients who are shopping for services.  A good faith estimate of expected charges will be orally provided when services are scheduled and/or costs are asked about.  A written document that is clear, understandable, in an accessible format, and in the language spoken by the patient will also be available.

HOW MUCH DO YOUR CHARGE FOR YOUR SERVICES?

For clinical services, I charge a flat fee for the specific services rendered.  I have agreed to accept the fee schedules of many health benefit payers.  I provide a cash discount for those who choose not to or are unable to use insurance.  For forensic services, I charge by the hour or per diem; I can provide an estimate based on the amount of information I need to assemble and the specific questions I must address.  For any assignment, at the outset I will discuss the fee arrangements with you and will only proceed when we have agreed on a satisfactory arrangement.