Insurance & Practice Policies
Natural Balance Wellness Medical Center is out-of-network for all insurance and we do not provide primary care services. Fees are collected at the time services are rendered and patients are given a superbill with standard diagnosis codes to submit to insurance for reimbursement or deductibles according to your out-of-network benefits.
Also, because we combine conventional medical care with complementary strategies, insurance may not always recognize our suggested treatment plan for reimbursement or deductibles. However, no services will be billed to you without your approval, and our fees will always be discussed related to any treatment plan prior to any decisions.
Simply stated, we do not interact directly with insurance, nor do we fall under any of their supervision. Our patients submit the billing documents we provide directly to their insurance plan and receive payment directly.
Some insurance companies will allow you to get a referral for out-of-network providers, which may lower your out-of-pocket expenses. Please check with your insurance company for more details. The referring physician would usually be your primary care physician.
Our clinic accepts personal checks, credit cards, and cash for all products and services. However, we encourage the use of personal checks as our preferred form of payment for larger purchases by charging a 3% credit card fee for larger purchases, such as multi-session neurofeedback, in-home hyperbaric chamber rentals, or products offered through our office at nearly wholesale prices: home water filtration systems, infra-red saunas, hyperbaric chambers, treadmill oxygen systems, etc.
We are often a pass-through entity for large products and your credit card company charges us between 3 to 5.8% for every credit card purchase. Without this additional fee for certain products, we would have to increase our prices.
While Natural Balance is out of network for all insurance, and we don’t bill your insurance directly, we will provide you with a superbill for every encounter with the appropriate codes to submit to your insurance plan for reimbursement to you directly.
But please know that we have literally given up on trying to figure out the whims of insurance plans and cannot guarantee you will be reimbursed as such. For your reference, the codes we usually provide with your superbill are provided below.
Please note: We can’t guarantee your insurance company will accept our superbills, diagnosis, or billing codes, and we do not play the insurance game to change their minds, fight denials, or support our clinical decisions. However, it’s usually not a problem with the vast majority of our patients enrolled with standard insurance programs.
99205 Medical Office Visit
99354 Medical Office Visit - Extra time
97802 Office Visit – Registered Dietitian
Medical Office Visit to Review Labs (example of a 1.5 hours lab review appointment)
99215 Medical Office Visit
99354 Medical Office Visit - Extra Time
Follow-up Visit (example of a 30-minute follow-up in-office appointment)
99214 Medical Office Visit
Follow-up Visit (example of a 30 minute over-the-phone appointment)
99443 Medical Office Visit
Please note: This is for informational purposes only, as our codes and pricing may change without notice. For specific pricing information and the most current coding document, please refer to the New Patient Process of the clinician, doctor, or program you wish to inquire about.
We require a 50% deposit to schedule your individual or bundled appointments with our clinic. As long as you notify us at least 3 business days before your scheduled appointment, you are welcome to reschedule or the deposit will be fully refunded, as per your preference.
However, if you cancel or reschedule your appointment within 3 business days of your appointment, with the exception of a “true emergency,” road closure, or some other extreme circumstance, your deposit will be forfeited.
Understanding how our clinic operates is imperative to our mutual success. Our protocols can sometimes be complex and require motivation on your part to implement. Our advice is to learn as much as you can during our early group patient education sessions and problem-solving visits and have confidence that, together, we will be successful.
We are a project-based Precision Medicine clinic, which means that our team tackles imbalances and problems in a logical order, using genetic susceptibilities and diagnostics as our guide. The average patient works closely with us for 1 to 3 years.
Many of the tests we use are cutting-edge and novel, but they can also be costly if you don’t have any insurance. Our physicians use the best testing options at the lowest out-of-pocket expense available to our patients and we never mark up testing.
We also use your insurance to the extent possible and specifically choose diagnostics that pose NO risk for costly insurance denials.
When you qualify for an EASY PAY or PAY ASSURED program, and you pay upfront for testing, you will not pay additional fees for any reason. Regardless of deductibles, denials, etc., all tests are paid in full unless otherwise stated.
We have put in considerable effort to provide a large selection of novel functional and genetic testing options for our patients with the best pricing, insurance coverage, and payment terms available.
Our nutritional pharmacy contains most of the nutraceuticals/supplements our physicians prescribe. Our private-label products are high quality brands offered to patients below the minimum advertised pricing set by the manufacturer, which is why we private label them in the first place.
Whether you buy them from us or elsewhere is not important, but they should be the same brands we trust. However, we are confident that you will not legitimately find them for less elsewhere. Please beware of bait-and-switch small print, soon-to-expire, or mishandled products on the internet. Even blatant counterfeits of our suggested products exist online.
As with the use of other products, Natural Balance Wellness Medical Center will not supervise or take responsibility for products other than the ones we are familiar with and have tested and scrutinized carefully. Read our full disclosure.
Supplements purchased from our clinic or online store are returnable within 30 days from the original date of purchase (with a receipt) provided there are at least 4 months until the printed expiration date. For safety reasons, we are unable to refund opened or temperature-sensitive products (for example, refrigerated probiotics).
In keeping with increasingly strict HIPAA regulations, we discourage clinical contact or clarifications via nonsecured email directly with our doctors. However, you may email our patient care assistants to answer short and specific questions or clarifications.
Please note: For clinical concerns that cannot be quickly or simply answered, you will be asked to schedule a paid phone consultation with our doctor clinicians so they can review your chart and provide the highest quality care possible.
For specific pricing information and the most current coding documents, please refer to the New Patient Process of the clinician or doctor you are working with.
- Level 5/ lab review session, scheduled for 60 minutes, will be charged $450 for canceling or rescheduling within 3 business days
- Level 5 follow-up visit, scheduled for 60 minutes, will be charged $370 for canceling or rescheduling within 3 business days
- Level 2 follow-up visit, scheduled for 20 minutes, will be charged $140 for canceling or rescheduling within 3 business days
Please keep in mind that we are a small and very personalized clinic. While most patients understand this, some expect us to operate like a larger clinic or hospital; solve their insurance or legal concerns; and provide letters regarding their health or disability, time off from work, or other related concerns.
While we recognize this is commonplace for doctors, our consistent experience has been that we are not able to address legal, disability, or insurance concerns. This does not mean we will not assist you in any way we can. We certainly will.
We just know that, based on experience, our way of looking at your health concerns is very different than the conventional standard of care, and we have generally found that we are not able to overturn insurance decisions or compete with conventional paradigms regarding your health or conditions.
Remember, our goal is to solve your complex health problems to the very best of our ability, and the true litmus test of our value should be whether or not we are helping you and/or your children feel better. To this end, we are confident you will be pleased with our approach and our results.