Eastside Menopause & Metabolism

INSURANCE & FEES

Insurance & fees,
made clear.

Eastside Menopause, Metabolism & Endocrine is a Direct Specialty Care practice. We don't bill or contract with any insurance company. You pay before your visit, and we give you the paperwork you need to seek out-of-network reimbursement yourself.

PAYMENT
Before your visit
PAPERWORK
Itemized Bill
ACCOUNTS
HSA & FSA

HOW PAYMENT WORKS

From your visit to reimbursement.

  1. Pay before your visit

    Payment is due before your appointment.

  2. Get your paperwork

    You receive an itemized bill, along with your diagnosis (ICD-10) and procedure (CPT) codes.

  3. Submit to your insurer

    If you have commercial insurance, send the bill to your plan to request out-of-network reimbursement.

Reimbursement depends on your plan, and we can't guarantee it.

CHECK YOUR BENEFITS

Questions to ask your
insurance company.

Before your first visit, call your insurer and ask about your out-of-network benefits.

  1. Does my plan include out-of-network benefits for physician office visits?
  2. What is my out-of-network deductible, and has it been met?
  3. What percentage of an out-of-network office visit will be reimbursed after my deductible?
  4. Is prior authorization or a referral required for out-of-network specialty care?
  5. Is there a limit on the number of out-of-network specialist visits covered each year?
  6. Do I need to submit a claim myself, or can I submit a bill provided by my physician?
  7. Where should I submit my claim, and what forms are required?
  8. How long does reimbursement typically take?

WHAT TO EXPECT FROM US

What we provide, and what we don't.

What we provide

  • An itemized bill
  • CPT and ICD-10 codes for your visit
  • Documentation of services, if your insurer requests it

What we don't do

  • Bill insurance companies
  • Submit claims on your behalf
  • Appeal denied claims
  • Talk with insurers about reimbursement
  • Verify or estimate your insurance benefits

GOOD TO KNOW

Paying for your care.

HSA & FSA

You can use your health savings.

HSA and FSA funds can be used for your visits. Please confirm eligibility with your plan administrator.

MEDICARE, MEDICAID & TRICARE

Government plans

We are unable to provide care to Medicare, Medicaid, and Tricare patients.