Insurance Concerns and Payment Policies
“Without Discipline, There is No Freedom” BJB

Robert Fortier-Bensen, M.D., APMC
Center for Functional Medicine

Pricing and Payment Policies

Investing in your health is a lifelong process and allows you to gain in wellness, energy, stability, and happiness. Material things such as new house, car, or a new stock are of no worth without good health. Only you can place a “value” on your health and decide what you want to invest in your health when it comes to out-of-pocket costs for your total healthcare.

At Center for Functional Medicine our focus is patient-centered health care that addresses the unique interactions among genetic, environmental, and lifestyle causes of complex, chronic illness, with the goal in mind for you to have the gift of good health!

Because of the uniqueness of our practice and the services we offer, unfortunately we are unable to participate in many managed care companies, however some insurance carriers understand the benefits of integrative and natural medicine services, including regenerative injection therapies, such as Prolotherapy, and reimburse for these services. We strive to provide the highest quality of care and will continue to help you, our patients, attempt to get the most reimbursement you can from your insurance company.

Please understand, however, that there is still no guarantee that insurance companies will reimburse for your treatments here, even after they have said “yes” to complete or partial coverage.

Regenerative therapy, including Prolotherapy and PRP [Platelet-Rich Plasma] injection therapies are our most sought out and popular treatments for chronic pain conditions. Currently, the AMA does not recognize a CPT4 code for PRP specifically, therefore reimbursement is not guaranteed by insurance companies. The most accurate way to determine costs is to schedule the initial consultation and let the doctor determine which areas should be treated, as each patient varies greatly.

All prices are explained up front and neither treatments nor lab testing are done without the patient’s prior approval. Feel free to let us know up front if finances are an issue.

Standard Payment Policy

We respectfully request that patients pay in full at the time of service. CFFM accepts MC/VISA/DISCOVER, debit cards, personal checks, and/or cash for payment of services (or any combination of the above).

Our Clinic will assist as a courtesy to patients with payment of all fees through helping you file for and processing insurance forms and mailing statements. This does not, however, change the fact that all patients have full responsibility to pay for all services rendered on their behalf. Patients are expected to make timely payments and to follow up with their insurance carriers as appropriate.

Medicare/Medicaid

Since Medicare/Medicaid have determined that they will not cover natural medicine services, including prolotherapy, Dr. Fortier-Bensen cannot be part of this system and therefore is an “OPTED OUT” physician with Medicare and is not a Medicaid provider. All Medicare patients are required to sign a private contract every two years, prior to any services being rendered. Dr. Fortier-Bensen, nor the patient, can file to Medicare for any reimbursement.

Pricing for treatments, medications, or consultations are subject to change at any time. Prices will be explained once the clinical information is available to give to the Billing Department.