The medical practice operates as a fee for service practice. Payments are expected at the time of service. This allows for more flexibility and freedom in the developing relationship between the physician and patient. We make every effort to keep this care affordable for all with the following options:
- Insurance: We can provide the proper paperwork needed for patients to submit claims themselves directly to their insurance company. Many insurers allow this service (and many patients have successfully made submissions) and reimburse at their regular rates. It is the responsibility of the patient/family to know if their insurance company allows this practice. With this service, we charge our full fee (still significantly less than the standard fees charged in the community–see below for examples) and require payment at the time of service.
- No Insurance: For patients/families without insurance or who do not wish to utilize the first option, we provide a discounted fee schedule dependent on the complexity of the visit (request details at the office). Insurance paperwork is not provided at this payment level. We do everything we can to keep this service affordable yet still viable (see below for examples). We hope people will value this care as much as other activities in life–with that in mind, let us know if special circumstances require further discussion.
- Phone Care: Phone calls can be a frequent part of care and often require quite a bit of physician time. To help keep overall practice fees affordable, there will be a small charge for some calls. Calls that are very brief to help determine if an appointment or after hours urgent care is required are offered at no charge. Brief calls that include discussion of a more detailed urgent care plan or more detailed office visit follow up will be charged at $5-15 for the call depending on the complexity. More complete phone appointments (if appropriate to care) will be charged at the regular discounted office fee schedule.
- Labs and Diagnostic Tests: Prescriptions will be provided when necessary for laboratory and diagnostic testing. It is up to the patient/family to know their insurance coverage and rules regarding any recommended testing. Some basic, in office tests will be offered and billed affordably as outlined above for general services.
- The medical office does have contracts with some of the Badger Care plans, United Healthcare and Anthem Blue Cross/Blue Shield (not BCBS Priority or Priority X Plans), and for these plans we are required to file claims for services to the insurance companies and cash pay discounts are not available.
General Outline of Fees (all approximations; subject to change without notice):
- Office Visits: Non-insurance–most common $70-$85 (range $45-$110 depending on complexity/length of visit)
- Office Visits: Insurance paperwork provided–most common $105-140 (range $65-$185 depending on complexity/length of visit)
- All first time visits in the new system include an additional one time $40- setup fee
- Phone Calls: As outlined above.