We Accept and bill health insurance
If you don't already know, insurance is a major hassle. Many offices are straight cash, or they require the patient to submit their own insurance. Costs for insurance are rising and benefits are lowering, and it is only getting worse.
We make it easy
We bill in and out-of-network insurance on your behalf, so you don't have to mess with it. We also accept liens in personal injury cases and we bill Medpay after a car accident, on your behalf.
We recognize that you may spent hundreds, maybe even thousands of dollars per month for your insurance, and you want to use it.
We have an in-house billing specialist who will verify your benefits and then talk to you about how your benefits will pay or not pay for services at Thrive Health Systems.
Medicare states: “Care that seeks to prevent disease, promote health, and prolong and enhance the quality of life, is not considered medically necessary.” Medicare (HCH 2251.3)
For this reason, we educate patients that you should not base your health care decisions on what insurance will or will not pay for. We understand personal and family budgets, but the insurance industry has made it very clear that it is not in the business helping your prolong or enhance your quality of life, which is exactly what you'd like to do. Be prepared to make decisions outside of your insurance benefits.
Also, it is important for you to know that even if you have insurance, you are ultimately responsible for you medical bills. Insurance even states on its call recording when we call to verify insurance that even though they may say they cover a particular procedure, they may not pay for that procedure, and any information obtained that day may not be accurate.
We have had an insurance company state that they will provide up to $50,000 for medical coverage for a post-car accident case, and then deny services rendered based on lack of medical necessity, determined by an out-of-state doctor who never saw the patient.
We have had an insurance company say that they do not require pre-authorization prior to treatment, and then flip flop and say they do and deny payments. We've submitted payments within 10 days of treatment and been denied for untimely submission (which is not until after 60 days).
The stories go on and on. The take-away is that it is a benefit that we bill for you, and that you are ultimately responsible for your medical bills. If your insurance company denies bills for services rendered, you will be billed for the service.