Payment and Insurance

Renovi Medicine is in-network with most private PPO plans, with the exception of Blue Cross Covered California plans.  We are not contracted with HMO/IPA plans.  Please contact your insurance provider prior to your appointment to confirm our network status.  

A large percentage of health practitioners who offer integrative holistic servicies do not take private insurance.   They provide service on a cash basis in order to properly devote resources and time to their patients.    We have worked with a number of these colleagues, and understand fully their decision to prioritize a practice model different from ours.  Currently, reputable holistic practitioners (physician staffed)  charge anywhere from $170 to $360 for office consultation, and a range of $250 to $400 for initial assessment (first office visit).

The insurance companies use statistics and utilization numbers to determine suitable reimbursement to your doctors' offices, hospitals, imaging centers, and lab facilities.  It is harder to quantify the value of holistic medicine care and assign the resources accordingly.  That's why most private insurance companies often do not factor in the longer time requirement associated with holistic medicine services.  They reimburse medical offices based on shorter office visits that are the norm of medical practice today.   Also, most insurance companies consider integrative medicine consult as "excluded" service, because most MD /DO practitioners are not trained in the field.

Renovi Medicine works with your PPO insurance.  We began with a vision to take care of our patients and their families, and bring about improvement in their health status that is sustainable.  Our leaders believe there are powerful tools that can provide additional insight to fixing health problems.   Not just that, we also want to practice "medicine" in a way that is truly accessible to working families, and not just limit our service to exclusive few.    So far, several thousand patients have benefited from our decision to practice "integrative" medicine this way.   They understand the extra work our physician and staff have to do, and how a practice like ours only gets compensated by insurance reimbursements at the same level as other primary care offices.

Using your private insurance

Our office is contracted with major PPO insurance plans.  That means we are bound by our agreement with them, just as you are contracted as a member with your health insurance companies.   As a courtesy, we will bill your primary and secondary insurance for you.  Providing current insurance information is the responsibility of the patient.  Please be prepared to provide your insurance card at all visits. After we file the claim with the insurance companies, they respond with Explanation Of Benefits statements that outlines how much the insurance pays, and how much we are required to collect from patients (co-pay, deductible, co-insurance etc).

For new patients, we collect insurance information before your first office visit with the doctor, and check for eligibility and benefits.   If there is any discrepancy, we will let you know.  We do that ahead of time so that there are no surprises to you and to the office when you arrive.

Once you are a regular patient, please let the office staff know whenever you update your insurance so that we maintain the most current profile for you.

Please note:  With the advent of Affordable Care Act (Obamacare), some insurance companies have Tier 2 and Tier 3 insurance packages that they offer to their members as "PPO" insurance, but various medical offices are not contracted with.  These tend to be newer insurance packages that require separate modified agreements between insurance and doctors' offices.   Several of our patients have told us that insurance company websites do not distinguish between the "original" PPO insurance plans and these newer, modified PPO insurance plans.   Thus, they might list our physician as accepting these modified PPO plans even though we are not contracted.  So, please check your insurance in determining whether this medical office accepts your type of PPO insurance.

What if you do not use PPO insurance

For patients who do not have private PPO insurances, we offer discount cash rate.  This is applicable to cash patients, HMO, or Kaiser members.   Our staff works diligently to verify your policy coverage and basic benefit details ahead of time.  Due to the wide variety of plans offered by companies, it is not possible for us to know all the specific details of your policy.  We encourage all patients to know their network, plan benefits, and restrictions.  

If at the start of your appointment, we are not able to confirm your eligibility status, and you believe you have a valid insurance coverage for our office, we would ask for you to pay the applicable discounted cash rate as we wait for the billing process.   We will make adjustments and refund any necessary amount later, based on your insurance EOB.

What about Medicare

Our office is not set up to bill Medicare.