Whether to have us Bill your Insurance or Not

Dear Patient,
This letter provides advice as to whether you want us to bill your private (non-governmental) insurance company. Each policy from each insurer is different so it makes it difficult for us to give general advice. Here, though, is our attempt:

1. If you haven't met your annual deductible then it is probably in your best interest to pay at time of service in order to avoid the extra expense of us billing for you. This cost is currently $20 per visit.
2. If you have only an office visit and no trigger point or acupuncture services it probably is less expensive if you pay at the time of service and bill your insurance company yourself.
3. If your insurance requires you to pay co-pays please do so at time of service.
4. If you have met your deductible and you receive acupuncture or trigger point work. it is generally best to let us do the billing for you. The trigger point procedure code is the code I use if trigger points are treated with dry needling or injected. Most insurance companies cover trigger point work provided by a physician whereas coverage for acupuncture can be more limited. The one caveat is that the trigger point procedure code only works with diagnoses associated with musculo-skeletal problems.

I apologize for how complicated this is. Please call the office and speak with the receptionist if you want further clarification about how we might help you get the most insurance coverage. In any event, you are ultimately responsible for your medical bill and if we don't receive payment within 45 days then we will bill you and expect prompt payment. Our discounted prices are only applicable to prompt payments at time of billing.

Sincerely,

James K. Rotchford, MD MPH

updated: 5/28/04