Appalachian Wellness

Insurance & Fees

We believe health care should be affordable. We’re one of the few integrative & functional practices to accept Medicare, NC-Medicaid, and other major insurances. Our mission is to help patients find affordable care options to recover and heal from complex chronic illnesses.

In Network vs Out of Network

When a doctor accepts your health insurance plan we say they’re in network. We also call them participating providers. When you go to a doctor or provider who doesn’t take your plan, we say they’re out of network.

In-Network Insurance

 

We accept third party payers including:

  1. Most of the NC Medicaid plans (Please contact office to ensure coverage)
  2. Medicare
  3. NC Blue Cross/Blue Shield
  4. Humana
  5. Cigna (except Wake Forest and Duke University).

Please review your policy for more details on your coverage—for instance, some Cigna policies have restrictions such as only being accepted at Duke University System facilities.

All other insurance companies are out of network/Non-Participating.   

Prior to your first office visit, please email (cao@AppWell.net) us a copy of your insurance card (front & back). This will allow us to provide a more accurate estimate of your total financial responsibility at your initial visit.

We will collect at the time of the visit any copay or Deductible etc.  If you have a high deductible, your insurance does not become effective until the deductible is met. You are responsible for paying your portion at the time of your appointment until you reach your deductible.

NOTE: Not all Medicare supplemental coverage is considered in our network and eligible for coverage.

We will have to contact your Supplemental Medicare Company and find out if your policy is “In-Network/Participating”.  Each plan is a little different. Before we call and check it please make sure you have Part B as this is the only type that is acceptable in our office.

We will let you know what to expect from your insurance company.

If you have coverage please make certain you have coverage for Prolonged office visits. If your insurance policy states that they only pay for up to an hour then make sure we make and keep your appointment under the guidelines of your policy. Each and every person’s coverage is different. We do not have the ability to look it up.   The patient is ultimately responsible for anything their insurance does not cover.

Out of Network Insurance or Self Pay

Anything not listed above in Network is considered out of network coverage.  So we do not accept Aetna, United Healthcare, MedCost, & other states’ Medicaid, That means we will collect a deposit of $500.00 as a deposit (for out-of-network/Non-Participating patients only) for your First Lyme or CIRS appointment.  At the time of your first appointment, you will owe the remaining balance of your projected fee prior to being seen.  Appointment fees are based on time spent preparing for your visit and during your visit as well as any additional testing deemed necessary.  Feel free to discuss with our office staff prior to your appointment if you have any questions.  Typically, our fees are $300 for the first 50 minutes patient time and $200 for each subsequent 50 minutes of time.  We also bill for the time spent preparing for your visit.   We will provide a copy of the paperwork so that you can send it to your insurance company and get reimbursed by your insurance. If they have forms that they use please provide them several days in advance.  If they need a copy of your chart then it is your responsibility to go into Patient Fusion and print off a copy and email it to them.  Excessive clerical time spent by our staff is also subject to a fee.

 

No Show / Missed Appointments

All missed initial appointments will be charged at full price for non-rescheduled or non-cancelled appointments.

Please email 2 full business days prior to your upcoming appointment in writing if you need to reschedule your appointment to provide proof of your cancelation at a minimum of 2 full days prior.

All schedule changes must be done 2 full business days prior to your appointment. 

There is a $100 charge for missed follow-up appointments.

All no-show visit charges will not be billed to your insurance but directly to you.

Fee Explanation

Pre and Post appointment time involves creating charts, transposing data, organizing your information, review of other information that may have been sent prior to appointment, while post-appointment work involves medication refills, care coordination, phone calls, Emails & prior authorizations for medications etc.  These services take time/money and will be billed according to permitted standards and billing codes used by Medicare, NC Medicaid and 3rd party insurers. 

$ 300.00 for the first hour and $200.oo for all additional 50 minutes.

$200 for each additional 50 minutes or $100.00 for each additional 25 minutes.

Nutritional Counseling $50.00 for 50 minutes.

We also provide referrals to trusted practitioners for other services such as mental health counseling, trusted sites for supplements, compounding pharmacies etc.

Your Health Starts Here

Contact us to schedule your appointment today!

Phone: (828) 785-1850 

Hours: 9am - 5pm Monday-Thursday

Appalachian Wellness

Better Health Care is Our Mission & Vision

Personalized healthcare for patients suffering with chronic illness in Western North Carolina

(828) 785-1850

rjodo@appwell.net

200 District Dr. #006, Asheville, NC 28803