Why Fee for Service?

April 7, 2016

Our office is inside the Emcura Integrative Medicine office and the providers here have decided the best way to provide the highest quality care for our patients is to be Fee for Service.  This means that we take payment at the time of the visit.  This allows us to spend extended time with each patient and make sure appointments run on time.  There is more patient time with the physician and no waiting.   At Mobility Medicine,  we then work with patients to try and get reimbursement from their insurance company.  For most insurances this entails filling out a one page claim form and submitting it, along with a detailed receipt from our clinic, to your insurance company through the mail.  Since health insurance is an agreement between the insurer and the patient, it is hard to know how much and what services will and not be covered.  At Mobility Medicine we bill for an office visit and if warranted Osteopathic Manipulative Treatment.  The office visit billing is just like any other physicians office you would see.  The codes for new patient visits are 99202-99205 and for follow up visits 99212-99215.  If Osteopathic Manipulative Treatment is warranted based on the evaluation of the office visit, then those codes are applied as well (98925-98929) depending on the amount of areas treated.  This is billed with what is called a 25 modifier which signifies a separate and identifiable procedure done on the same day as the visit.  CMS/Medicare defines these as reimbursable and so to should your insurance company.  That being said, all insurance companies are different so we highly recommend you check with them if you are going to seek reimbursement.  It would be covered through out-of-network benefits.  We are a member of Medicare, but a non-participating member.  That means that you still pay for the entire visit at the time of service, but if you would like we can submit to Medicare on your behalf for reimbursement to you. 

 

While this is a lot of information and it can be quite confusing, our goals are to provide the highest quality care for you.  Please do not hesitate to contact our office for any questions.

 

 

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