Many people would like to know what insurance coverage, if any, they might be able to access when seeing one of our Renewed Vitality providers. So here’s the information that we explain to all of our patients.
In terms of your office visit with the doctor or nurse practitioner, we are an out of network provider. The reason for this is that when a practice chooses to accept insurance, insurance companies tell the practice how much time they can spend with each patient, what illnesses and conditions they can treat, and how they can treat it. In order to get to the root cause of the problem and provide optimal treatment we find we need more time with our patients and more treatment options than insurance companies are willing to work with.
If you have a PPO plan, very often insurance companies will reimburse you for much of your office visit costs. You will pay for the appointments at the time of service and we will provide you with the necessary papers to file for reimbursement with your insurance provider.
If you are on an HMO plan, most likely your insurance will not cover any of the costs of your office visits, but will likely cover all or a majority of your lab work.
Regarding the lab work that will be required, many insurance plans have changed how they pay for lab-work. You may now have to meet your deductible before your insurance pays anything for labs. This could mean a significant increase in your cost for lab-work.
In order to better serve our patients at Renewed Vitality, we can now save you up to 85% off of Quest’s list prices. Through Renewed Vitality, complex lab orders cost approximately $500, and less complex orders are closer to $300.
Until recently we have informed that if they have insurance, they have the option to pay for lab-work through their insurance provider. We have recommended the lab that was in network for your insurance so that coverage would be approved and you would have little to no payment for the lab-work. This was possible due to the majority of insurance providers considering lab-work to be a medical necessity, so they would either completely pay for the lab-work, regardless of your deductible, or ask you to pay a co-pay of 10% to 20% of the invoice.
However, over the last couple of years, we have noticed a shift of insurance policies that have moved away from that model. Now in many cases, insurance will not pay anything until your deductible is met. Even after your deductible is met, they may only pay 80-90% of the invoice and you will be billed for the rest. We have seen this multiple times during the past year. Because we don’t know what your insurances rates are, we cannot predict how much your lab-work will cost. With many patients’ deductibles currently above $3000 a year, this makes it very expensive for patients by having to pay 100% of the cost of their lab-work until their deductible is met.
With this information in hand, we then went directly to the lab companies with two goals in mind. First, we wanted to see if we could negotiate lower lab prices so that we could lower the costs for our patients. Second, with those lower costs, we could then predict the amount patients would pay for labs each year and that way we could better help you plan your medical expenses. Thankfully, we have been able to get better prices from the lab company for the tests that we repeatedly order and have been able to lower our cash prices for you!
This means more complex lab orders cost approximately $500 and smaller lab orders checking selected tests will cost approximately $300.
To find out what your insurance will cover I encourage you to call the customer service number on the back of your insurance card and ask a few basic questions. First of all tell them that you’re going to see an out of network provider. This means someone that is not on the insurance list of doctors. That said most PPO plans understand that people would prefer to see a doctor that they researched or that comes highly recommended from a friend. Ask your insurance company what the deductible is and what percent they will reimburse for the office visit with an out of network doctor or nurse practitioner.
When talking to your insurance customer service, tell them that your out of network provider is going to order very comprehensive lab work. Ask them specifically what percentage of the lab costs they will pay. If it is 90-100% you are better off to use your insurance. If they will cover less than 75% you will be better off to use the Renewed Vitality laboratory discount program. For your convenience, Renewed Vitality Dallas has a Quest Diagnostics Lab located right in our office.
Care Credit is another option for help in covering the cost of your appointments and lab work when needed. We accept Care Credit, which is a separate company from Renewed Vitality. It can be used to pay for labs as well as any other services or products at Renewed Vitality.
- Must be at least $200.00 per transaction
- Zero interest if paid within 6 months (Renewed Vitality Only Offers the 6 months no interest)
- If you take over 6 months to pay it off, interest is charged, starting retroactively from the purchase date. You will need to contact care credit directly for more info, or to apply go to carecredit.com or call (800) 365-8295.