Why do we not take insurance?
We get this question all the time from our patients and prospective patients. The answer is that if we took insurance as a panel provider we would not be able to do most of what we are presently able to do. In fact, we would not be in business at all by now.
We do not take insurance, not because we don’t want to, but because insurance companies do not provide adequate coverage for the services we offer and no coverage at all for “wellness services”. Reimbursements are very low for panel providers and this is why with practitioners in the insurance model, visits are reduced to 6-10 minutes because practitioners have to see 40-50 patients per day to have a sustainable practice. We could not do what we do with patient care, including deep dives into disease history and finding root causes in an insurance model with 6-10 minute visits. At that point, we would be indistinguishable from the providers that most of our patients have already seen and not gotten the results they are seeking.
Strangely enough, as an out of network provider that gives superbills, our patients often get far higher reimbursements than we would get if we were directly billing. If deductibles have been met, it is not uncommon for insurance companies to reimburse patients in the range of $500-$600 for our 2 hour initial comprehensive chronic illness visit which is $975. Typically reimbursements are 70% of reasonable and customary.
Payments for initial visits that have occurred are not refundable. Generally, programs are non-cancellable for the stated term. In the event that Proactive agrees to cancel a program, none of the fees paid to the point of the cancellation are refundable. This is due to the fact that there is a significant amount of effort to create the individualized program, the initial prescriptions and provide services that are heavily front-loaded. Scheduled future payments will be cancelled if Proactive agrees to the cancellation.