Insurance & Billing

Payment

Payment is due at the time of the visit. You should submit to your insurance company for reimbursement if you have out-of-network coverage. Checks or cash are expected at appointments.

When you make your first appointment we take a credit card number from you, and you also give us permission to automatically bill your credit card for any balance due on your account (such as for zoom appointments, email consultation, missed appointments, returned checks, and other fees for services done outside of an office visit).


Visits with Dr. Ginsburg

NOTE: A visit can take longer than expected, such as if a problem turns out to have a high degree of complexity. Times are estimates. Call us if you need clarity about your visit.  Dr. Ginsburg’s hourly rate is $300.

 Type of Visit Time  Cost
 Initial Visit  60m to 80m $300 to $400 
 Initial Visit for ASD (Autism Spectrum)  80m or more $400 or more 
 Well Child Visit  40m $200 
 Well Teen Visit  60m $300 
 Gynecological Exam/Visit  60m $300 
 Follow Up Visit  40m to 80m $200 to $400 
 Follow Up Visit for ASD (Autism Spectrum)  40m to 80m $200 to $400 
 Urgent Care Visit  20m to 40m $125 to $200 

 

Visits with Nutritionist Stephanie Goodman

For patients that see Dr. Ginsburg first, some of the visit to the Nutritionist may be eligible for reimbursement IF you have out-of-network coverage. Please ask us for a special invoice for this. 

Type of Visit Time Cost
 Initial Visit 60m $150 
Follow Up Visit  40m to 60m  $120 

 

Insurance

Healing Oceans does not participate with health insurance company “networks”.

This means we are “out-of-network” for your insurance reimbursement. We do not accept their decision about how long the doctor should spend with you to address your issues, nor how much money they think it is worth.
Insurance companies usually allow big dollars for surgery and drugs, but much less to figure out and address root problems. Dr. Ginsburg’s rates are among the most reasonable in the region for the work she does, but she spends more time with patients than most insurance companies allow.

Your visit can be be covered by your insurance plan if it covers out-of-network visits. The amount that is covered is affected by two things:

  • You need to meet the deductible of your insurance plan. No reimbursement happens with out-of-network care until you meet this.
  • The insurance company will decide how much of the charge for the visit is “reasonable and customary” (their term). Dr. Ginsburg’s rates are  inside this “reasonable and customary” range.
    Since a holistic and integrative certification is a higher level of skill, such doctors usually charge more than that. In our area of the country, holistic family doctors generally charge between $350 and $600 per hour.

Separating from the craziness of insurance plans was a difficult decision for Dr. Ginsburg because it would leave some of her patients without coverage to see her. Committed to being accessible by as many people as possible, she sets her rates where they are and created the membership plans described below for very young children.

If you have any kind of managed care plan like an HMO or PPO, most likely you are required by them to have all your lab testing done at a laboratory and testing company that has a contract with your plan. Non covered tests: Why your insurance company does not pay for certain tests and treatments. Unfortunately, no laboratory company performs every test.

Also, holistic medicine today uses tests that other doctors (and insurance companies) often do not know about or understand. They use these tests to obtain more or different kinds of information than the conventional tests. One group of such tests is called functional testing, which report on the changes in a body over time, like a movie, instead of just the state at a particular moment (i.e. conventional blood test), which is more like a simple photograph.

What this means is that there are some tests you will have to pay for out of pocket. This happens regardless of how important you or the doctor think the test is. We have all heard the stories of patients having to legally fight their insurance company to pay for expensive tests that are covered under their policy.

The insurance company will still say that they pay for anything your doctor recommends be done, as long as it’s medically necessary. But that’s the catch. They get to decide what is medically necessary, not the doctor. There is an exception: if you have out-of-network benefits, usually you will get  reimbursed, at least partially.

Medicare and Medicaid

We do not participate in Medicare or Medicaid. Patients who are enrolled in them cannot be reimbursed by those programs for seeing Dr. Ginsburg, and must sign an affidavit of accepting this. Medicare does not use one particular lab–there are only a few lab companies they use. And they only cover certain tests, even if they are done in the labs they like.

Never covered by any insurance
Insurance will also not reimburse for any non-prescription treatment, including vitamins, minerals, herbs, nutrients, digestive aids, etc., regardless of how helpful they may be. Insurance will also not pay for certain types of therapies, even if there is a ton of evidence that they will help your condition. Included in this list is acupuncture, massage, classes on stress management, homeopathy and many more.

Again, it does not matter what the doctor thinks will be beneficial to you, and it does no good to ask them. This system was designed by the insurance companies themselves. They are simply non-covered services to the insurance company, and the company prospers by finding ways to not pay.

NSF (bounced check) Fees and Collections

If your payment is refused or bounces, you will be charged $30 and any bank charges incurred, and you are given 14 days to make payment. After that you are charged a late fee of $5/month.

Invoices not paid within 120 days are subject to patient dismissal and submission to a collections agency. If we must remit your account to our collection agency, an additional 30% of the balance owing (including late fees) will be charged to your account.

Late Cancellation and Missed Appointments

Appointments that are cancelled less than 48 business hours before the appointment, as well as missed appointments, are charged 50%, of the cost of the scheduled appointment. Exceptions may be made at our discretion based on your circumstances. 

 

Other Services

We understand patients have needs that arise outside of regularly scheduled appointments. We want to be sure everyone understands our fee structure for all services. By making this clear, we hope to foster smooth relationships between Healing Oceans and our patients.
 

Prescription Refills

Our office handles prescription refills differently than many other practices. Patients should contact us for prescriptions refills.

We do not accept phone call or faxed refill requests from pharmacies. Please inform your pharmacy not to contact us for refills. Medications are refilled during your visit with the doctor.

We ask patients take responsibility for knowing when their prescriptions need to be refilled and scheduling appointments accordingly so refills are not needed between appointments. We generally do not refill prescriptions between visits. When an exception is made, there is a $25 fee.

Form Completion

There is no fee when a form is completed during an appointment. Outside of appointments, the fee is $25. Some forms, such as for disability, require an appointment.

Questions/Consultations with the doctor via e-mail

Communication by e-mail is reserved for non-urgent matters. It may take up to 72 hours for a reply, but it is often within 24 hours.

There is no charge for brief e-mails requiring only a quick response.

Longer emails or emails requiring a longer or more detailed response, as well as frequent emails, will be charged at our hourly rate of $300. These will be pro-rated based on the amount of the doctor’s time needed to read your email and respond, as well as to complete any work requested in the e-mail.

Copying Records

Digital records are $1 per page, to a maximum of $50. Paper copies are $1 per page, to a maximum of $100. Remember that you can print for no charge, using the patient online portal, Elation Passport. This includes your labs, studies, immunization history, and correspondence from other physicians or health care practitioners. 

Letters

Any letter you request from Healing Oceans, such as to advocate for payment for denied labs, to request certain accommodations at work or school, etc., has a fee. The fee is based on our hourly rate of $300 and is pro-rated to the amount of time needed to gather the information and write your letter.

Before writing such a letter, we may advise an alternate course of action as well.

Creating or Updating a Lab Slip or a Prescription

After your office visit, if you request a change to a lab or pharmaceutical prescription, this involves looking up, reading, and changing your records. For this, we charge a $25 fee.