INSURANCE

Please also do your own eligibility and benefits check in addition to the electronic one Motherhood to Menopause will do before your visit. The information below is generalizations and not specifics to any one plan.  

As a free service to you, I will do an electronic eligibility and benefit review of your active and current benefits.  To do this, I will need a copy of your health insurance card(s), front and back and your date of birth.  I will not be calling the insurance plan for additional information for coverage or network status.  

I prefer to be paid by a credit card, benefit card or similar.  A check will be accepted though not cash.  Make checks payable to: MOTHERHOOD TO MENOPAUSE AND SENT TO MY HOME-BASED OFFICE.

PROFESSIONAL FEES WILL BE SUBMITTED TO MOST INSURANCE PLANS.  AT THIS TIME: I AM CREDENTIALED IN-NETWORK or CONTRACTED WITH MOST CARRIERS (THOUGH NOT WITH ALL OF THEIR POLICIES).

SELF PAYING CLIENTS:  FEES ARE DUE THE SAME TIME OF YOUR APPOINTMENT AND A DISCOUNT IS PROVIDED.  

MY FEES ARE WELL-UNDER MARKET AND NOT WELL MATCHED BY OTHER PRACTICE - THIS INCLUDES TIME SPENT FOR AN APPOINTMENT, RELIABLE AND CREDIBLE RESOURCES,  THAT INCLUDES ACCESS TO ME THROUGH TELEPHONE, TEXT AND EMAIL.  

Each health insurance carrier/plan has different policy types - while one policy may cover some services another policy may not even if within the same employer and sometimes even when the member ID is the same though the group number changes - there is policy changes.  

Your policy may require a referral before being seen by Motherhood to Menopause.  You can request one through your primary care provider (PCP). Your policy may also be a "self-insured" product which means it wants you to stay within a specific network of providers or you chose to stay within a certain network of providers for your care.  

INFORMATION YOUR HEALTH PLAN WILL NEED TO DETERMINE MY PRACTICE NETWORK STATUS:

Practice Tax ID:  86-1178138

Practice National Provider ID (NPI):  1861080103

Provider NPI:  1124016449

Individual and family deductibles are dollar amounts that need to be met regardless whose threshold is crossed.  And most often co-pays are due at the same time. This means to spend your health care dollars with providers who are most interested in your healthcare needs and wants.

This is the breakdown, similar to 80/20, for example: Insurance pays 80% of the allowable amount (note it is not the amount submitted) - it is appreciably less -  and you pay 20% - after you have met your deductible.

Once you have reached your individual/family out of pocket max you may pay nothing towards your visit cost while insurance would completely cover the allowable amount though there still MAY be a co-pay due.  

For laboratory services, I utilize QUEST for processing of specimens that can be collected at Motherhood to Menopause. There also is the option for me to order and for you to schedule labs at one of their Patient Service Centers (PSC).  

I utilize Rayus (formerly known as Center for Diagnostic Imaging (CDI)) for mammograms, scans for bone loss, screening for osteopenia or osteoporosis and other GYN screenings.   

I do abdominal/transvaginal dating ultrasounds for those persons greater than 6 weeks, check baby position, check placenta location, evaluate amniotic fluid levels and post-dates pregnancy testing: biophysical profile (BPP). Ultrasounds with me do not evaluate the structural integrity of your baby.

I am able to measure the intrauterine lining for those intending pregnancy and for those who are experiencing irregular vaginal bleeding or for post-menopausal break through bleeding.