Check with your insurance company about coverage prior to scheduling any visits!

If we accept your insurance we will bill you for copays, coinsurance and deductible amounts per your insurance plan and per our contract with the insurance company. Please make sure you understand your deductible and your copay and coinsurance responsibilities.

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If you think your insurance will pay for our services it is your responsibility to check with your insurance company before any visit in order to confirm the following:

1. That the clinician you want to see is in-network with your insurance plan.
2. That you understand any referrals, authorizations or prescriptions that might be required in order for your insurance to cover our services.
3. That you understand your deductible and any co-pay/co-insurance amounts that may be due for our services per the terms of your insurance plan

When you contact your insurance you can give them the codes listed on our Pricing Page as examples of the codes we may use during a visit

IMPORTANT NOTICES:

• Out of State Blue Cross / Blue Shield: Many out of state BCBS plans do not cover the services of our clinicians. Always check with your insurance to make sure our services are covered before scheduling your appointment.
• Other Private insurers: We are not in-network with any other private insurer or insurance network not listed above. This includes Aetna, Cigna, Optum and United Health. If you are covered by these insurers you will have to pay out-of-pocket for our services.
• HMO plans: We are not in-network with any HMO plan, including Kaiser Core or Premera HMO or any other HMO plan. If you are covered by an HMO plan you will have to pay out-of-pocket for our services.
• Medicaid: We are not in-network with Molina, Amerigroup, Apple Health or any other Medicaid plan. If you are covered by these insurers you will have to pay out-of-pocket for our services.
• Medicare: Medicare does not recognize our physicians or any of our other clinicians. If you have Medicare Part B you must notify us in advance. You will likely have to pay out-of-pocket for our services even if you have other insurance.
  • Medicare Advantage and Medicare Gap plans will also not pay for our services.
  • There are a small number of Regence, Uniform Medical and other BCBS plans that will pay primary to Medicare – meaning they pay first, before Medicare. If you believe you may have one of these plans please call the number on the back of your card before filling in our forms. If your plan does not pay primary to Medicare you will be responsible for payment for all services rendered.
  • Medicare will not pay for labs or medications if they are prescribed by our physicians. Many of our medicare patients work with other doctors to manage their labs and medications.
• L&I Workers Comp: We do not work with L&I claims. If your condition is due to a work-related injury please let us know before scheduling. You may have to pay out-of-pocket for our services.
• Auto/MVA/PIP: We can only work with some auto or other accident insurance claims. If your condition is related to an auto or other accident please let us know before scheduling. You may have to pay out-of-pocket for our services.

We do not have any financial arrangements with any lab companies. You will need to pay the lab companies directly or confirm that your insurance will pay on your behalf. If we are in-network with your insurance company then there is a greater chance that you can use your insurance to pay for standard lab tests and also some of the advanced lab testing that may be recommended by your physicians at Heart of Wellness.

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