Thank you for choosing Rebel Med Northwest and its providers for your medical treatment and care. We are committed to providing you with quality and affordable health care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we developed this payment policy. Please read it, ask us any questions you may have, and sign in the space provided. A copy will be provided to you upon request.

1. 1. 1. Insurance.
         1. We participate in most insurance plans that we are eligible, if you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage.
         2. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.
         3. While we are in-network with many health insurance networks, your particular insurance plan may not provide coverage for naturopathic, acupuncture, spinal manipulation, nutrition, or massage therapy.
         4. Some insurance companies may require pre-authorization before receiving certain procedures, if you know this is the case, please let us know, so we can help facilitate any processing of forms to ensure timely care is achieved.
      2. Co-payments, Co-insurance, and deductibles. All co-payments, co-insurance, and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.

      3. Non-Covered Services.

         Please be aware that some and perhaps all of the services you receive may be non-covered or not considered reasonable or necessary by your health insurers. You are responsible to pay for these services. We typically bill for office visits & various procedure codes specific to each licensed provider’s scope of practice. It is your responsibility to understand your individual insurance coverage, and will be informed of potentially non-covered services and costs prior to your appointment.

      4. Proof of insurance. All patients must complete our patient information form before seeing the doctor. We will make a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
      5. Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
      6. Coverage changes. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.
      7. Non-payment. If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice.

      8. Missed appointments.

         1. It is the policy of Rebel Med Northwest to allow clients to cancel appointments without charge 24 hours prior to their appointment. For appointments cancelled on the same day as the appointment, Rebel Med NW will use best efforts to rebook the appointment.

         2. If unsuccessful, clients will be charged 50% of the appointment cost unless the cancellation was within 2 hr of the appointment or the customer was “no show, no call” for which the customer will be charged the full price of the appointment.
         3. For “same day” booked appointments, customers are allowed a one-hour grace period from time of booking to cancel their appointments without charge. Thereafter, same day cancellation policy rules apply.

      9. Typical Billing Codes:

         1. Office visits –99201-99398 We provide and bill for office visits on most visits. Office visit services include provider consultation time spent with you discussing your particular medical issue(s), treatment plan, etc. These charges are easily recognizable on your explanation of benefits as they start with numbers 99. Occasionally, charges for office visits may change your deductible, copay or coinsurance for that particular visit. You may wish to consult your insurance company regarding any changes to your coverage based on a “specialist” office visit.
         2. Manual Therapy Codes-97140. Our Naturopathic Physicians also use the manual traction code 97140 for the bill for muscular manipulation work they do. This particular code can also be used by Physical Therapists, Chiropractors and possibly other healthcare professionals. You may wish to check with other providers to see if they are billing this code for your visits.
         3. Physical Medicine Codes – Naturopathic Physicians provide spinal manipulation services (Codes 98925-98929), mechanical traction (97012), manual therapy (97140), trigger point injections (20552,20553) and have patients perform specific therapeutic exercises (97110). If you are seeing a physical therapist, chiropractor or other physical medicine providers we recommend having them call us to coordinate care and benefits.
         4. Acupuncture Codes – 15 minute needle insertion (97810,97811) Acupuncture with E-Stim (97813,97814), Office visit codes (99202-99203, 99212-99213), manual therapy (97140), Infrared Heat (97026)
         5. Other Codes. Our providers also provide Therapeutic ultrasound (97035), Electrical Stimulation(97032), Contrast Hydrotherapy (97034); Injection therapy (96732,J3420,J3415,J3411)
         6. Biofeedback – (90901) Biofeedback refers to the use of biofeedback equipment to improve awareness of the nervous system and its effects on health.
         7. Massage Therapy – (97124) used for the purpose of massage therapy, as medically necessary, with a prescription, and performed by licensed massage therapists.
         8. Nutrition Visits – (97802, 97803) – nutrition counseling codes.

      10. Appointment Length

          1. ND Office Visits – 50 minutes for first office visits and up to 25 minutes return visits. Extended time charge for longer return office visits.
          2. Acupuncture Visits – 75 minute first office visits & up to 50 minutes return visits
          3. Nutrition Visit – up t0 25-50 minutes of time
          4. Biofeedback / VR Exposure Therapy Visits – up to 55 minutes of treatment time
          5. Physical Medicine Visits – up to 30-45 minutes depending on procedures performed
          6. Medical Massage Therapy – includes up to 50 minutes of massage time
          7. IV Therapy Visits – 30-90 minutes depending on consult, volume, & nutrients.
          8. Extended time appointments with Naturopathic, Massage, Acupuncture subject to extended time fee or non-covered services fees.
          9. Rebel Med NW Concierge plan provides coverage for extended time visits, non-covered services, lab services.
      11. Lab Services – non-covered lab processing fee required for all labs drawn at Rebel Med NW
          1. Labcorp & Quest Labs – can be billed to your insurance for medically necessary labs – subject to your individual insurance policy for co-insurance/deductible patient responsibility.
          2. Direct Pricing Labs – direct pricing paid through Rebel Med NW for labs not-submitted to insurance
          3. External / Auxiliary Lab Evaluations – Subject to non-covered waiver policy for all labs, for example: food intolerance testing, micronutrient testing, genetic, stool microbiome testing
          4. Lab Interpretation Fee applies for labs requiring extra time associated with treatment plan development prior to separately billed office visit / nutrition visit.