Dr. Wheaton is enrolled as a provider in most insurance groups in Minnesota. If he is a provider for your insurance company your office visit charges will be submitted by our billing department. You will NOT be charged for this at the time of service. Each insurance company varies in their payments for our charges. We agree to accept their discounts and their payment for the charges. However, your agreement with your insurance company may require that you pay a certain percentage of the charges (such as a copay, deductible, or a percentage of the services provided). In this case you agree to be fully responsible for your portion of your bill.

 

Pre-authorizations or referrals to be seen or treated at this clinic is your responsibility. You are responsible for knowing what your plan will cover. If you have questions, please contact your insurance company.

 

In some cases you may be treated with services that are considered “investigational” or “medically unnecessary” by your insurance company, treatments such as prolotherapy. Charges for these services will not be submitted to your insurance company. Non-covered procedures are charged at the time of service, while covered services will be billed to your insurance company. This policy/agreement serves as notice that the procedure, prolotherapy, will not be billed to your insurance, unless authorized in writing, in advance of treatment. You will be provided with a treatment estimate prior to treatment which will outline costs, number of treatments, and length of treatments. By signing this agreement, you agree that you have been informed that this is not a covered procedure and that you will be responsible for the full payment at the time of service.

Five years ago Dr Wheaton made the difficult decision of opting-out of the Medicare system. Dr. Wheaton is not currently a Medicare provider (under the Social Security Act), he has again chosen to opt-out of the current two year period of 2006 & 2007. Therefore, as required by Medicare, all Medicare patients must enter into a private contract with Dr. Wheaton. You may choose to seek care from a participating physician, or if you do enter a private contract with Dr Wheaton this will not affect your status with other participating Medicare physicians. This contract states that you will be responsible for the full amount of all charges at the time of service, as Medicare will not make payment for any services. Medicare limits may not apply to our charges. As a Medicare beneficiary you agree to not submit any claims to Medicare from our office, or ask us to submit claims as this would be a violation of our agreement with Medicare.

 

Medicare plans do not, and other supplemental insurance may elect not to make payments for services not paid for by Medicare. Most require that a claim must first be processed by Medicare. Because Dr. Wheaton is not a Medicare provider we cannot submit claims to Medicare, so supplemental insurance often will not pay for these services either.

 

If services are provided due to an emergency, no private contract with the patient is required.

 

You will be provided with an estimate of all costs involved in your care with Dr Wheaton

Worker’s compensation may cover prolotherapy in some cases, but this must be pre-authorized and presented in writing prior to treatment. We will assist you with this pre-authorization process.

Auto insurance companies often cover prolotherapy when your claim is open and active. However, we require full payment at the time of your visit. You will then be given all the necessary paperwork for you to submit these charges to your auto insurance for reimbursement.

Any patients without current health care coverage will be required to pay their charges in full at the time of service. We do have payment options available through Care Credit, simply ask for an application or apply online at www.carecredit.com. They offer various interest-free plans.

All copays are due at the time of service. You may pay these by cash, check or credit card. We accept both VISA, Mastercard or Discover.