New Patient Guide

The short answer is it depends!

It depends on which provider(s) you see and for how much time they put into your care. It also depends on whether you receive any “separately identifiable” services or procedures as defined by Medical Coding (What is Medical Coding?) and what your insurance company is.

Despite thousands of medical codes, not everything we recommend corresponds to a billable code, so we charge in full upfront or per an agreed upon auto-payment plan. This is true of many supplements, nutrient therapies, classes and care from non-medical providers.

Our Know Your Insurance Worksheet contains useful questions to ask your insurance company that can help you understand your coverage and benefits. Find this in the Shared Documents section of your patient portal, in the General Resources folder.

We contractually bill BlueCross BlueShield affiliated companies (Regence, Premera, LifeWise, and quite a few others) for anything that corresponds to a CPT code (What are CPT codes?)

We bill upfront for anything that does not correspond to a CPT code and for copayments (What is a Copay?) As soon as your insurance finishes processing claims, we will bill you for any amount deemed your responsibility, including deductible and coinsurance (What is a Deductible and Coinsurance?)

For patients with no or any out-of-network insurance (What is Out-of-Network?), we charge time-of-service rates for everything up front and, upon request, we can submit a claim to your insurance for anything that corresponds to a CPT code, but we cannot guarantee that you will receive any reimbursement. If you do, great! If your insurance pays us, we will ask you if you want it refunded or applied to future care.

We typically bill for the Total Time our providers spend on the day of your visit: preparing to see you, your actual appointment duration, plus any time required to coordinate your integrative care.

We may also bill based on the complexity of the provider’s Medical Decision Making. Either way, this is Evaluation and Management, and we routinely use the following CPT codes:

• New patient visit codes: 99202,99203,99204,99205+/-99417
• Established patient visit codes: 99212,99213,99214,99215+/-99417
• Evaluation and management / care coordination services on dates without an appointment, including portal / email care: 99358,99359, 99421,99422,99423

We will bill Preventative codes when applicable, but our providers usually incorporate preventive services into more comprehensive Evaluation and Management(see above) so most exams and check-ups at Village Medicine are not coded as exclusively free services.

Be prepared for your usual out-of-pocket costs for a 60+ minute visit in addition to any minor procedures or recommended testing.

There are a multitude of possible procedures and affiliated charges. We maintain a comprehensive but incomplete list in your Shared Documents > General Resources section of the portal. Please check with us and your insurance before receiving any procedure to ensure you do not get a surprise bill!

Our providers rely on multiple laboratories for the best science has to offer for insight into human health. We cannot guarantee how your insurance company will process claims for testing.

Your insurance determines what you pay out-of-pocket based on what the lab bills. We have limited resources with which to predict what will or won’t be covered by your particular plan. LabCorp is our primary lab for routine blood tests and bills most insurance companies.

Specimens collected in our clinic may incur fees for preparation, processing, and/or shipping, which are in addition to what the laboratory processing your specimen(s) will charge! If you have questions about costs of testing, it is best to contact laboratory directly. If they need more information, you may request they reach out to our clinic on your behalf.

We charge based on Suggested Retail Prices as determined by manufacturers.

We charge based on time and expertise of the provider.

Our Providers will track and typically bill for the total time they spend preparing to see you, your actual appointment duration, and any time required to coordinate your integrative care.

We will require you to review our full policies and pricing in your patient portal prior to making any appointment(s).

Fees are charged to the most recently added card on file unless a prior arrangement is made.