Fees / Insurance
Fees and insurance can be somewhat tricky to understand, so we’ve broken this information out to help you navigate your options. If you need additional assistance, our team is happy to assist you.
INSURANCE OVERVIEW
How We Work with Insurance
Our practitioners are credentialed as In-Network with the following Insurance Companies. Please take a moment to call your insurance company to better understand your “Naturopathic Medicine” and “Acupuncture” coverage benefits.
If you cannot find the name of your provider (Dr. Dishman, Dr. Weintrob, Michelle Hirschy-Baker) on your Insurance carrier’s website, try searching under INSPIRED HEALTH. All of our practitioners at our clinic share a Tax ID under this name – this is often how Insurance companies will list our providers as In-Network.
In-network insurance companies for oregon residents
- Regence BCBS: Blue Cross Blue Shield (Panel currently closed to Medicare/Medicare Advantage)
- First Choice
- Moda (Panel currently closed to Medicare/Medicare Advantage)
- Pacific Source (Panel currently closed to Community Solutions/OHP/Medicare/Medicare Advantage)
- Providence (Panel currently closed to Medicare/Medicare Advantage)
- Aetna (Includes PPO and POS – Excludes EPO)
- EBMS
- Meritain – Facebook Employees
- Cigna – only Dr. Ari Weiner is in network
Deductibles
If your deductible has NOT been met, and it applies to a service being rendered – WE WILL COLLECT A PORTION OF YOUR VISIT FEES TO BE APPLIED TOWARDS YOUR DEDUCTIBLE.
The remainder of your invoice will be billed to you once we have collected an EOB (Explanation of Benefits) from your Insurance.
If we collect from you and your deductible has been met, once the billing charges have been processed and finalized by your insurance company and Inspired Health, you will be credited back the money owed to you.
Labs
STANDARD CONVENTIONAL LABS
You will need to know your Lab Benefits – many insurance companies are NOT covering labs, and they will often be applied towards your deductible if billed through your insurance carrier.
If you get a “time of service” cash discount for standard blood work labs (Interpath or St. Charles), you cannot then submit the bill to your insurance. If labs get billed directly to your insurance and you get a bill, the lab cannot go back and give you the cash discounted rate.
SPECIALTY FUNCTIONAL HEALTH LABS
Our providers order specialty Functional health labs through ReNew Functional Health LLC – in order to provide access to discounted pricing. ReNew Functional Health LLC is NOT in-network with any Insurance providers. These labs are typically NOT a covered benefit.
Functional Medicine
Functional Medicine is a different approach from the existing health care insurance model. Conventional Medicine is truly a disease-care model, and Functional Medicine is a modern health care model.
- The Functional Medicine model requires a unique approach to your care that can NOT be accomplished in a standard 10-15 minute visit. We give you our TIME and focus on root-cause medicine. Our practitioners are in-network with some insurance plans. Often the time it takes to deliver you an individualized support plan is not completely covered by insurance. Most Functional Medicine clinics across the globe are cash-based and do not accept ANY insurance.
Our clinic will do our best to get as much of your care covered as your insurance plan allows.
- If your insurance company does not pay for any portion of your treatment, you will be responsible for the charges. It is your responsibility to be aware of what services are covered.
- Often we will bill the code 99417 to allow for reimbursement towards the time it takes to deliver true Functional Medicine (Lab review, Preparation of Review of Findings, Customized treatment plans, Coordination of care, etc)
- Functional Medicine + Customized Support Plans / Lab Reviews: some visits are longer than the standard office visit codes provided by insurance companies. Your practitioner creates a typed-up Interpretation of Lab Results, including a Support Plan prior to “Review of Findings” appointments. These documents are customized and created for each individual and can take more time than the allotted standard office visit codes used for all Insurance companies
Fee Schedule
Insurance Deductibles
If your deductible has NOT been met, and it applies to a service being rendered –
WE WILL COLLECT A PORTION OF YOUR VISIT FEES TO BE APPLIED TOWARDS YOUR DEDUCTIBLE.
The remainder of your bill will be collected after your Insurance has been billed.
The following amounts will be applied to your deductible at checkout.
NATUROPATHIC
FUNCTIONAL
MEDICINE
FIRST APPOINTMENT – DEDUCTIBLE COLLECTION FEE
$275
RETURN APPOINTMENT – DEDUCTIBLE COLLECTION FEE
$180
NATUROPATHIC
FUNCTIONAL
MEDICINE
+ ACUPUNCTURE
FIRST APPOINTMENT – DEDUCTIBLE COLLECTION FEE
$300
RETURN APPOINTMENT – DEDUCTIBLE COLLECTION FEE
$195
ACUPUNCTURE
FIRST APPOINTMENT – DEDUCTIBLE COLLECTION FEE **ONLY FOR LABOR WELCOMING & MOTOR VEHICLE ACCIDENT PATIENTS
$165
RETURN APPOINTMENT – DEDUCTIBLE COLLECTION FEE
$100
CASH PAY OVERVIEW
How We Work with Cash Pay
Due to State medical regulations, Inspired Health is unable to bill insurance for OUT OF STATE clients, and you will be unable to file with your insurance company for reimbursement. If you are an OUT OF STATE resident, we will collect the appropriate Discounted Time of Service Cash Pay Rate on the date of service.
If you are an Oregon resident and we are NOT “In-Network” with your Insurance Company – we will give you a Superbill receipt of your services, so that you can submit it to your Insurance Company to get reimbursed directly.
You likely have “Out-of-Network” benefits that this would be applied towards – check with your Insurance carrier.
The Lab Review is the most timely and efficient way to determine the underlying root causes of your health concerns and design a customized and effective treatment strategy. The Lab Review fee structure is designed to save you money and time over the long term by performing the appropriate diagnostic and physiologic testing and evaluation before treatment begins.
Fee Schedule
Cash Pay
The fee for supplements recommended as part of your treatment strategy after the Lab Review is typically $100-300. Additionally, the following amounts will be due at checkout.
NATUROPATHIC
FUNCTIONAL
MEDICINE
FIRST APPOINTMENT
$422-576
INITIAL / COMPLEX LAB REVIEW OF FINDINGS
$295-449
FOLLOW UP AND/OR MINIMAL COMPLEXITY LAB REVIEW
$148–295
NATUROPATHIC
FUNCTIONAL
MEDICINE
+ ACUPUNCTURE
FIRST APPOINTMENT + ACUPUNCTURE
$495
INITIAL / COMPLEX LAB REVIEW OF FINDINGS + ACUPUNCTURE
$283–449
FOLLOW UP AND/OR MINIMAL COMPLEXITY LAB REVIEW + ACUPUNCTURE
$283
ACUPUNCTURE
FIRST APPOINTMENT **ONLY FOR LABOR WELCOMING & MOTOR VEHICLE ACCIDENT PATIENTS
$217
RETURN APPOINTMENT
$125-173
Telehealth
INITIAL APPOINTMENT
$422-576
FOLLOW UP + MINIMAL COMPLEXITY LAB REVIEW
$295-449
FOLLOW UP AND/OR MINIMAL COMPLEXITY LAB REVIEW
$148–295
LAB TESTS OVERVIEW
Standard Conventional Labs + Specialty Functional Health Labs FAQs
The costs of Laboratory tests recommended during the case review process varies depending on the complexity of condition and level of diagnostic testing required. Laboratory testing is typically $150-1500 (depending on the number of lab tests required for each individual case).
Our practitioners utilize a collaborative approach with other specialists (General Practitioners, Gastroenterologists, Reproductive Endocrinologists, etc) wherever they can, in order to create a team of support for each individual patient.
STANDARD CONVENTIONAL LABS
You will need to know your Lab Benefits – many insurance companies are NOT covering labs, and they will often be applied towards your deductible if billed through your insurance carrier.
If you get a “time of service” cash discount for standard blood work labs (Interpath or St. Charles), you cannot then submit the bill to your insurance. If labs get billed directly to your insurance and you get a bill, the lab cannot go back and give you the cash discounted rate.
SPECIALTY FUNCTIONAL HEALTH LABS
Our providers order specialty Functional health labs through ReNew Functional Health LLC – in order to provide access to discounted pricing. ReNew Functional Health LLC is NOT in-network with any Insurance providers. These labs are typically NOT a covered benefit. See information below.
ReNew Functional Health LLC – Info and Process
WHAT IS RENEW FUNCTIONAL HEALTH LLC?
ReNew Functional Health LLC is a platform that supports practitioners and patients with the Functional Health lab testing process. Renew Functional Health is not actually a lab, and does not process samples. They handle payment, shipping and communication between your provider and several specialty lab companies.
WHAT IS THE PROCESS?
- Your provider places an order for lab testing through ReNew Functional Health. This order may include testing from one or more laboratories.
- You’ll receive an estimate of charges from us with details about your lab test order.
- To move forward, you’ll provide us with your shipping information, and payment for the labs.
- You will either receive the test kit in the providers’ office, or we can ship the kit(s) out to the address you specify.
- If your kit is an at-home test, you’ll simply complete the test and ship it back to the lab with the pre-paid shipping label that comes inside the kit.
- If your kit requires a blood draw, you’ll need to wait until you receive a kit in the mail. ReNew Functional Health will send you customized phlebotomy options based on your location. Look out for a portal message titled “Lab Test Estimate” for more information and instructions.
- Bring the kit with you to the blood draw. The person that draws your blood will ship the kit back to the lab for you. Know that there may be an additional cost involved with the blood draw.
- Once the lab has processed your sample and results are ready, they’ll be sent directly to your provider, who can share them with you in your appointments.
ReNew Functional Health LLC – Payment Info
PAYMENT FAQS
CAN I USE INSURANCE FOR MY LAB TESTS?
ReNew Functional Health accepts payments for lab tests, but we don’t interact with your insurance directly in any case and we are not contracted with any Insurance companies.
You can pay for tests using credit card, an HSA (Health Savings Account) card or an FSA (Flexible Spending Account) card. You can also pursue insurance coverage retroactively through your insurance company by submitting your ReNew Functional Health invoice receipt.
The only case where your insurance will be involved is for lab tests from Diagnostic Solutions Labarotory (GI-Map Stool Testing), if you decide to bill your insurance company. In this case, you will pay Diagnostic Solutions Laboratory directly, and will pay Renew Functional Health for the Administrative handling fee.
HOW CAN I USE HSA OR FSA CARD TO PAY FOR TESTING?
You can put your HSA or FSA card number right into the payment page.
Note that some HSA/FSA providers have strict requirements on what vendors they accept. For this reason, it’s possible that your card will fail even though lab testing through ReNew Functional Health is HSA-eligible. If this happens, you can reach out to your HSA or FSA provider and see if you can submit your ReNew Functional Health receipt retroactively to them.
CAN I GET A SUPERBILL OR A RECEIPT TO SUBMIT TO MY INSURANCE?
We provide an itemized receipt for lab tests paid through ReNew Functional Health. To submit this to your insurance, you’ll also need ICD-10 diagnosis codes from your provider, and CPT procedural codes for your labs. You can get these CPT codes from each individual lab by reaching out to the lab directly.
- Aerodiagnostics: (617)608-3832
- Cyrex Labs: (877)772-9739
- Diagnostic Solutions Labs: (877)485-5336
- Doctors Data: (630)377-8139
- Precision Analytical: (503)687-2050
WHAT IS YOUR RETURN POLICY FOR KITS?
Patients have 30 days from payment to return a lab test kit. To be eligible for a return, the kit must be unopened.
How to Initiate a Return
- Ship your kits back to us: 550 SW Industrial Way, Building 2, Ste 100. Bend, OR 97703 You are responsible for paying for return postage.
- Once we receive your kit, a restocking fee of 20% will be charged upon refund to your initial payment method.
- Login to your Patient Portal to notify your provider’s clinic of your return.
Policy details:
- All returned kits need to be received back at ReNew Functional Health within 30 days of payment for a refund to be processed.
- You are responsible for paying for return postage.
- The refund will be for the full price minus 20% of the test returned to the same payment method.
RESULTS
WHERE CAN I VIEW MY RESULTS?
We send your lab test results directly to your practitioner, who can then share them with you. Legally we’re required to release results to your practitioner, who will then share with you. However, if you want to get them before – you can ask your provider if that’s ok, and once we hear from them, we can send them over.
Blood Testing
For specific conditions: such as high cholesterol/lipids, autoimmune disease, gluten sensitivity, food sensitivities, Leaky Gut, vitamin/nutrients status, chronic infections.
Advanced Comprehensive Stool Testing
to screen for beneficial bacteria status, gram negative bacteria, yeast, parasites, intestinal inflammatory markers (IBS, IBD), dysbiosis.
Hormone Testing – Saliva, Serum and/or Urine
- DUTCH Testing through Precision Analytical
- Conventional Hormone Blood testing (Interpath Labs, St. Charles Lab)
Organic Acid Microbiome Testing
The Organic Acids Test (OAT) offers a comprehensive metabolic snapshot of a patient’s overall health with over 70 markers. It provides an accurate evaluation of intestinal yeast and bacteria. Abnormally high levels of these microorganisms can cause or worsen behavior disorders, hyperactivity, movement disorders, fatigue and immune function.
Genetic Testing
For methylation anomalies and detox capabilities.
SIBO Breath Testing
- For SIBO (Small Intestine Bacterial Overgrowth)
