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Rates, Insurance & Fees

  • Insurance Plans
  • Out-of-Pocket Rates
  • Labs, Supplements, Etc
  • No-Show/Cancellation/ Rescheduling/Late Fee
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Insurance Plans

As a courtesy, PCNH will bill your primary & secondary insurance on your behalf. It's essential we have complete & accurate information about your insurance plan(s) before your appointment(s) take place. If you are new to the clinic, or if your insurance has changed, please share your information &/or photos of your new insurance card prior to your scheduled appointment(s).

If we are not notified in advance that your insurance has changed you will be responsible for the full amount of the service &/or procedure. This policy is in place to protect our patients from fraudulent claims in the event of identity theft.

In Oregon, most commercial/private health insurance companies offer plans that provide coverage & benefits for appointments with Naturopaths/Naturopathic Doctors. 

Naturopathic Doctors are licensed medical providers in the state of Oregon, so many insurance companies cover Naturopathic medical services in the same way they cover an appointment with any other type of physician.

There are many different health insurance plans that offer a wide variety of different coverage & benefits even within the same insurance company. It’s important to be familiar with your own health insurance benefits before seeking care at our clinic.

 

UNACCEPTED PLANS:

  • Medicare of any kind
  • Medicaid, of any kind
  • ASH Network (except Aetna)
  • Cigna, of any kind
  • Kaiser, of any kind
  • CHP, of any kind
  • Trillium, of any kind
  • Tricare, of any kind
  • Cascade Health Alliance, of any kind
  • Klamath Falls, of any kind
  • AARP, of any kind
  • VA, of any kind
  • Regence Legacy LHP Network
  • HealthNet, of any kind
  • Lifewise, of any kind
  • First Choice Health Network

Accepted Oregon-based Insurance Plans:

In-Network:

  • Aetna (including Meridian & Meritain)
  • Allied Health
  • GEHA
  • Moda, (including Connexus, Affinity, Beacon, Synergy, CCN, OHSU & HMC)
  • Health Management Association (HMA)
  • Motor Vehicle Accident insurance
  • Providence Health Assurance ( Out-of-Network only for Dietician/Nutrition Appointments. )
  • PacificSource
  • Regence / Blue Cross Blue Shield (including Anthem, Bridgespan, Premera, and Regence Group Administrators)

Out-Of-Network:

  • United - Out-of-Network Only!

OTHER:

  • Health Savings Accounts
  • Flexible Spending Accounts

Note :: please verify with your account directly the following items before you use your account for services here at PCNH: Is Naturopathy/Naturopathic Medicine, Specialists &/or Dietician/Nutritional Counseling covered benefits? Are there limits to your coverage?

 

PATIENT RESPONSIBILITY

Ultimately, it is the patient’s responsibility to know what their benefits are. Please remember, “Covered” does not always mean” Pay” and copay’s may be different for an exam than a spinal manipulation. Your insurance benefits are not a guarantee of payment; they are only a quote from your insurance company. We will make every effort to follow benefit guidelines. Although, you are still responsible for making sure that all required authorizations, pre-certifications and physician’s prescriptions are in order prior to and during treatment. Since the insurance world likes to change things for all of us (both patients & health care workers) without notice, it’s inevitable that something may fall through the cracks when it comes to insurance coverage. Here are a few examples of what may happen :
  • Prior Authorization is/was required.
  • Referral from your Primary Care Provider is/was required.
  • Underpayments leading to an Outstanding Balance can occur if your plan/coverage changed.
We want your insurance to work with you, not against you!    

How to Check Your Benefits for Naturopathic Medicine & Dietician/Nutrition Coverage

If you’d like to find out if your insurance plan offers benefits & coverage for Naturopathic &/or Dietician/Nutrition medical services, here are a few things you can do: 1. Review your insurance plan portal, handbook & policies.
  • Sometimes your insurance plan documents will specifically say if Naturopathy/Naturopathic Medicine &/or Dietitian/Nutrition is covered.
  • If you have an HMO plan you may be limited to seeing providers who work for that company (for example Kaiser). In most cases these plans will not cover naturopathic medicine.
2. Call your insurance company. To check your insurance benefits, call the customer service number on the back of your insurance card. Ask for benefits/coverage/eligibility. Tell the phone representative you’re calling to verify your insurance benefits & coverage. Here is a general list of the questions you may want to ask your insurance:
  • Does my policy cover services that are performed by a licensed Physician &/or Dietitian?  (If your insurance is unsure, you can ask if your policy specifically excludes Naturopaths as covered providers in its definition of physician.)
  • Is there a specific deductible I need to meet in regards to these services?
  • How much of my deductible do I still have to meet this year?
  • Is <Provider's Name> in-network with my specific plan?
  • What is my copay or coinsurance in regards to these services?
  • Is a referral required from my Primary Care Physician in order to see <Provider's Name>?
  • Is there any other pre-authorization required?
  • Do I have a maximum number of visits, or a maximum dollar amount for these services each year?
  • If your health insurance plan does not cover Naturopathic &/or Dietician/Nutrition services, you can still make an appointment! Please review our out-of-pocket/cash rate below!
  • Specialist vs. PCP :: We are not credentialed & considered as primary care providers (PCPs with any insurance company. We also do not bill as PCPs. We’re credentialed as, considered as & bill as Specialists - Naturopathic Doctors. As mentioned on our website & on our New Patient Application as a statement you agreed to to confirm your application: "We offer primary care services, but according to commercial insurance, we are not defined as a primary care physician (PCP): we are defined as specialists (naturopathic physicians).”

Note on Primary Care

We do not offer primary care. Please establish care with a primary care physician (PCP) if you have not already done so.

We are not credentialed & considered as PCPs with any insurance company. We also do not bill as PCPs. According to commercial insurance, we are not defined as a primary care physician (PCP): we are defined as specialists (naturopathic physicians).

TELEHEALTH/TELEMEDICINE

Many commercial/private health insurance plans cover Telehealth/Telemedicine services provided via video conference or telephone.

Since Naturopathic Medicine is regulated at the state level rather than the federal level, you need to be a current Oregon resident, located in Oregon at the time of your appointment, in order to have a Telehealth/Telemedicine with any of our Naturopathic Doctors.

If you would like to schedule a Telemedicine appointment with us, you will need to first make sure that the doctor you choose is a covered provider within your plan: We provide a courtesy insurance benefits check with each submitted application!

OUT-OF-POCKET RATES

We also accept out-of-pocket payments if you are not able to use insurance for any reason.

New Patient Appointments

This visit includes 55/60minutes of time spent together either virtually or in person. This includes out-of-state clients as well. A comprehensive history is taken and labs/imaging are ordered, if necessary or indicated. Initial treatment guidelines are initiated and goals are defined.

Follow Up Appointments

Will be discussed during your first visit.

LABS, SUPPLEMENTS, ETC

Laboratory Testing

Specialty labs are generally not covered by insurance, but as a courtesy, we’ll provide you with a superbill, if you request one, that you can submit yourself to your insurance to try to get reimbursement. Fees for laboratory testing are not included in the cost of office visits. Conventional tests may be covered by your insurance provider, although cannot guarantee coverage. Fees for laboratory testing are not included in the cost of appointments. Lab test pricing and insurance reimbursement depend on the specific test, insurance benefits/coverage, and laboratory used. 

We do our best to be conscious of using insurance, HSA, etc. when possible and only order what we deem necessary.  If you don’t have insurance and will be paying out-of-pocket, we contract with discount labs and can provide transparent pricing. Comprehensive blood work typically prices will vary. Payment for appointments do NOT include potential on-site blood draw, urine dip, cost of labs, imaging, &/or supplements.

If you plan to to pay out-of-pocket for labwork, we recommend Ulta Labs :: Instead of paying a lab you visit to complete your lab order we create for you, you can use Ulta Labs for much cheaper! Note: Ulta Labs works primarily with Quest labs.

Food Intolerance Evaluation

The Carroll Food Intolerance Evaluation is never & not covered by insurance of any kind. This is an out-of-pocket cost.

Prescription Medications

Private insurance benefits typically cover all or most of the cost of prescription medications. Compounded medications may not be covered. Contact your insurance carrier for details. Generally, I cannot prescribe medications for clients/patients that live out of the state of Oregon unless you can pick up the RX in Oregon.

Supplements & Natural Medicines

The cost of supplements vary. Supplements are required to be paid in full before they're given out.

Specialty Testing

Non-lab specialty testing prices will vary. They are rarely/never covered by insurance. Specialty testing kits are required to be paid in full before they're given out.

Payment Plans

We offer Square Afterpay payment plans for balances over a certain amount. Payment plans will include a 3% fee (we are charged 6% to offer payment plans but we handle half of the fee, 3%, to make it more accessible).

No-Show/Cancellation/Rescheduling/Late Fee

Rescheduling & Cancellation Policies

Applicable Fees

Notice of cancellation/rescheduling less than 48 hours will incur a fee and automatically be charged to the card on file ($125 fee for New Patient Appointments and $99 fee for all other appointments). If you no-show to any appointment, your card on file will automatically be charged the $125 fee for New Patient Appointments and $99 fee for all other appointments. These fees cannot/will not be billed to insurance, and are entirely your responsibility.

New Patient Questionnaires Requirement :: If you show up to your appointment without completed Questionnaires, you no-show to your appointment or need to reschedule due to incomplete Questionnaires, we will have to charge you the $125 fee since we need to abide by our policies.

Payment Options

Our Payment Options

We accept credit cards, debit cards, checks, ACH bank transfers, Cash App through Square, as well as cash.

Payment Plans :: We offer Square Afterpay payment plans for balances over a certain amount. Payment plans will include a 3% fee.

Still have questions?

Reach out to us and let us know how we can help. 

We take a personalized,
 patient-centered holistic approach 
to help elevate your health so you feel better.

Healthy, thriving wholeness is within reach for everyone.

What our Patients say about us

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