Insurance
If you require additional information please Contact Us.
Question 1: If I have Medicare or Tricare, how much will is cost me to come to The Clinic?
Answer 1: If you have Medicare or Tricare, since Dr. Henkin is a Medicare and Tricare participant, all clinic fees, except deductibles, are covered by your part B insurance. If you have Medigap Insurance, this covers most fees at The Clinic.
Question 2: Will my present health insurance cover my costs at The Clinic if I do not have Medicare?
Answer 2: Since all tests and procedures at The Clinic have been deemed medically necessary your personal health insurer should honor all costs of your visit here. However, the amount of this coverage will vary dependent upon your plan, your premiums and your deductibles. Depending upon your coverage you may come to The Clinic as “in-plan” or “out-of- plan”. Usually, insurance companies will pay a lesser amount to go “out-of-plan” than “in-plan”. The practice of The Clinic has been recognized as “medically necessary”. We have been designated “an accepted medical practice” by the Office of Personal Management of the US government. Blue Cross/Blue Shield has approved all tests performed at The Clinic as necessary for diagnosis and treatment of these disorders; however, The Clinic does not participate with Blue Cross/Blue Shield. Fees at The Clinic are dependent upon your problem and the need to perform those specific tests necessary to establish your diagnosis. You may ask about a payment plan to cover your care at The Clinic if you live in Washington, DC or the surrounding area in Maryland or Virginia.
Question 3: Is The Clinic considered a specialized service?
Answer 3: The Clinic is an extremely specialized facility which offers you clinical testing and treatment which is not available at any other facility in the world. The Clinic depends upon specialized personnel and equipment which are expensive to maintain and operate. The reagents, chemicals and other expendables required for your care at The Clinic are expensive. The tests required to measure your biochemical changes are complex and expensive to perform. In addition, a great deal of time, effort and expense went into the development of each special test required to understand the cause and initiate the treatment of your disorder. Costs for these services continue to rise due to their unique and specialized character.
Question 4: What are the fees at The Clinic and what do they cover with respect to my sensory dysfunction?
Answer 4: Fees for services at The Clinic vary but cover your complete initial care at The Clinic. This initial fee is for an all-inclusive series of services. This fee includes the four basic initial services at The Clinic: (1) initial complete evaluation of your sensory dysfunction; (2) reevaluation of the results of this complete evaluation; (3) treatment based upon your personal complete evaluation; (4) monitoring of your treatment (based upon your personal treatment plan) after you leave The Clinic. After you are treated at The Clinic you will contact The Clinic at regular, specified time periods by use of FAX, email and/or telephone. Using these contacts you will communicate with The Clinic about your progress on your treatment plan. Based upon your responses changes in your treatment plan may be made so that your responses to treatment can be maximized.
Question 5:
What practical steps do I take to get my insurance company to pay
for my visits to The Clinic?
Answer 5: As a Medicare and Tricare provider we will process all Medicare and
Tricare claims for you and will bill you directly for any co-payment of
deductible expenses not covered by your supplemental insurance. No advance
payment is required from you except for those services specifically identified
as non-covered Medicare or Tricare services which you will specifically request
in writing.
If you have your own medical insurance, as a service to you, we will file medical insurance claims for your care at The Clinic in order to relieve you of the burden and hassle of this process. If you find your insurance company unresponsive to your requests for full or speedy payment of your claims we have instituted a special service to help you. To do this we will assist you in this payment process in any manner that we can to make your insurance company honor its financial commitments to you.
However, there are some problems which you may encounter with your insurance company. We wish to help you identify these problems before you come to The Clinic so that we can assist you with your insurance. Some of these problems are:
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If you live outside the National Capital Area local insurance companies will not process your claims directly and will delay payment through various bureaucratic tactics. These delays on the part of insurance companies have resulting in payment delays to The Clinic of 4-12 months. These delays severely restrict our ability to perform those services necessary to care for you and these restrictions are not acceptable for The Clinic to operate on a sound basis.
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Premiums you pay for your medical insurance vary greatly with respect to type of policy and medical coverage. Variations in coverage occur based upon your relationship with your plan and plan location in the U.S.
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Premiums may cover a limited list of medical disorders and may not cover disorders which require specialist medical care.
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Reimbursement of medical fees by your insurance plan, albeit considered medically necessary, may differ greatly with respect to repayment schedules. Most insurance companies prefer to pay claims at the schedule of least medical care regardless that you are receiving care from a specialist physician service.
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Allowable charges insurance companies pay for services both within and outside the National Capital Area vary greatly and cannot be predicted since they are set idiosyncratically by local insurance bodies. This commonly results in payment to you by your insurance company of less than the usual and customary fees for specialist care. This lower payment may also reflect payment of insurance deductible charges and CO-payment fees. These problems have severely restricted our ability to perform those services medically necessary to care for you.
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The issues noted above are commonly not discussed with you in dealing with local insurance representatives since this may limit client participation in the various plans available. Repayment schedules for medical procedures supposedly covered by your insurance policy are also commonly not revealed to you by your local insurance company. Payment delays, improper and/or inappropriate reimbursement by insurance carriers and other issues have, on occasion, inhibited The Clinic from performing the work necessary to care for you in the manner you deserve.
We will assist you with these problems as best we can in order for your evaluation and treatment at The Clinic to be as effective as possible.
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