General Practice Questions
How does your practice work?
Why do you have a direct pay medical practice?
How is this good for patients?
Insurance and Payment Questions
How much does this cost?
Do you take insurance? Will you bill my insurance?
Will my insurance reimburse me for this care?
Can I get reimbursed from Medicare?
What if I am not enrolled in Medicare Part B?
How can you charge considerably less than other medical providers and remain in business?
What forms of payment do you accept?
Why must I pay at the time of the visit instead of you sending me a bill?
Clinical Questions
What are the advantages of working with a physician board certified in Obesity Medicine?
Do I need to have a primary care doctor? Does Dr. Geidl do primary care?
Will I lose weight?
Will Dr. Geidl prescribe medications for me?
Does Dr. Geidl recommend vitamins/supplements?
Do you treat children?
Do you take care of patients who want or have had bariatric surgery?
How does your practice work?
We will provide you with personalized medical care, and you pay for services provided. Our prices for care are clearly posted so there won’t be any surprises. Like most other businesses, we require payment at the time of service. Finally, if you have insurance, we provide you with a detailed receipt for you to submit to your insurance company. If your policy allows it, you can choose to send it to your health insurance provider and have the amount applied to your deductible or for reimbursement as an “out of network” provider. For more details, see our Direct Pay page.
Why do you have a direct pay medical practice?
I went into medicine to take care of people and help make them better. However, over the past few years, increasing government interference, insurance regulations, and ever changing Medicare laws are interfering with my ability to do this. Further, the amount of unnecessary procedures, unrelated to actually providing my patient quality care, has expanded significantly. Needless paperwork, as well as endless new rules and regulations are increasingly dominating the time and energy that I would prefer to spend helping patients. And if that wasn’t enough, the consequences for not tracking and complying with these ever-expanding regulations are substantial. Being a direct pay medical practice lets me bypass the vast majority of these issues. The result is that you have a doctor that is not worrying about bureaucracy and regulations, but instead the actual details of your care and wellness.
How is this good for patients?
By removing insurance company and government bureaucracy from the doctor/patient relationship, the doctor works for you. You can rest assured that any choices we make about your care are not influenced by your insurance company, nor any other organization that may directly or indirectly gain by those choices. We are able to respond to your needs only, not the demands of the insurance companies. This type of care is truly about what is best for you. Furthermore, because we are not bogged down with bureaucracy and paperwork that has nothing to do with making you better, your doctor is more readily available, and more time is available for your care. Additionally, by opting out, we are also now able to provide care in ways that are not possible via the traditional system.
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How much does this cost?
Our office has taken every opportunity to reduce overhead, increase efficiency, and keep your cost to the bare minimum. For specifics, see our Straight-Forward Pricing page.
Do you take insurance? Will you bill my insurance?
Northwest Metabolic Medicine does not participate with any insurance providers, nor do we submit claims or contact your insurance provider on your behalf. Although we don’t submit claims directly to your insurer, we will give you an itemized medical receipt which can be used if you wish to file an “out of network” claim with your insurance company.
Will my insurance reimburse me for this care?
Because Dr. Geidl is a board-certified physician, providing medical care for recognized medical conditions, many insurance carriers do offer partial reimbursement for her services as an out-of-network provider (subject to any deductibles and coinsurance provisions). Additionally, patients should be able to use their Health Savings Accounts and Flex Spending Accounts to help pay for this care. We encourage you to discuss coverage with your insurance carrier to be educated on what your policy covers for an out-of-network physician.
Can I get reimbursed from Medicare?
A Medicare Part B recipient can absolutely be seen at our office, but unfortunately Medicare will not pay or reimburse for this visit. The government has very complex and specific rules that apply when a doctor has “opted out” of Medicare Part B. When a physician opts out of Medicare, Medicare will not cover, nor pay that physician for any services provided. Further, a Medicare recipient may not ask Medicare to reimburse for any services performed by such a physician. A person covered by Medicare is allowed to enter into a “private contract” with a physician who has opted out. In a private contract, the Medicare beneficiary agrees to give up Medicare payment for any services performed by the physician and pay the charged amount themselves (also be aware that Medicare supplemental insurance policies usually do not provide coverage when Medicare doesn’t). And, the doctor who chooses to opt out of Medicare may provide care to Medicare beneficiaries ONLY through private contracts (they are not free to choose to see some patients via the Medicare system and some via private contracts).
Note that by entering into a private contract with us, you are not prevented from receiving services from other physicians who have not chosen to opt out. Also, there will be NO change to your overall Medicare benefits. Your Medicare and any secondary insurance benefits will continue to be in full-effect for labs/ x-rays, medical equipment, hospital services, and also for services you receive from other doctors that remain contracted with Medicare. Finally, Medicare patients must sign an acknowledgement of this at their first visit, and are required to re-acknowledge this, in writing, every two years when we renew our opt-out agreement with Medicare.
What if I am not enrolled in Medicare Part B?
Medicare private contracts do not apply unless you are enrolled in Medicare Part B. For example, patients who reach Medicare age but are still employed and covered by their employers’ (or spouses’) insurance can choose to enroll in Medicare Part A, but not enroll in Medicare Part B. Patients who aren’t enrolled in Medicare Part B will then not be considered Medicare beneficiaries for the purpose of their treatment, as described above, and will not need to sign a private contract (until such a time as they later enroll in Medicare Part B). Or, conversely, if a Medicare-eligible patient is covered under their employer’s insurance, but also chooses to enroll in Medicare Part B (so that Medicare will serve as a secondary payer), a private contract then would be required.
How can you charge considerably less than other medical providers and remain in business?
Because of the way the insurance companies and the government have interfered with the pricing of medical services, the prices have become inflated. It has resulted in a system where the insurance companies are, in effect, collecting a large amount of money in premiums and then in turn paying out a large amount for routine medical care. However, this is an inefficient system:
▪ Insurance company processing costs: It costs insurance companies a significant amount of money to process these millions of claims. Researchers estimate that just the administrative inefficiency alone results in $150 billion of additional unnecessary spending (beyond the cost of actually processing claims every year).
▪ Insurance company profits: Insurance companies, of course, collect a profit for providing their service.
▪ Physician processing costs: Insurance companies have created an extremely complicated set of rules and procedures that must be followed in order for physicians to be paid for the care that they provide. This requires a staggering amount of time, effort, staffing, and expense for your local physician’s office. By some accounts, these costs consume around 40 cents of each dollar that is spent for insurance-paid care. By “cutting out the middlemen”, we cut out a lot of effort, time, and overhead, and that 40 cents of every dollar can be spent on your actual care (which in turn lowers your cost dramatically).
What forms of payment do you accept?
We will collect payment from you at the time of your appointment. You can pay with cash/check, or debit and credit cards (including HSA/FSA cards).
Why must I pay at the time of the visit instead of you sending me a bill?
With insurance-paid medical care, there is often no way to know how much a visit will really cost, or how much a patient will owe after a claim has been settled. This is not possible because of deductibles, maximum out of pocket amounts, plus every insurance company pays a different rate for the same services . Under a direct-pay model, we know exactly how much the cost will be because we post our prices in the office and online. Further, we require that people pay at the time of service because this significantly reduces our costs (which, in turn, lowers the cost of your care). It is really not any different than the way you pay for your groceries, or for your oil change at the local mechanic, or to have your hair cut by a hairstylist.
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What are the advantages of working with a physician board certified in Obesity Medicine?
Board certification, with rigorous and specialized training in Obesity Medicine means that Dr. Geidl provides a more comprehensive approach. Some benefits are:
▪ Ability to address medical problems (such as high blood pressure, cholesterol issues, diabetes, PCOS, etc.)
▪ Ability to prescribe medication, plus management/adjustment of your existing medications
▪ Ability to perform advanced metabolic testing not available from most providers
▪ Providing ongoing laboratory monitoring and interpretation
▪ Providing exercise clearance and recommendations
▪ Providing customized nutritional guidance
▪ Experience with and ability to individualize and modify the approach for each patient. This is not “one size fits all” care.
▪ Providing body composition monitoring with state of the art equipment.
Do I need to have a primary care doctor? Does Dr. Geidl do primary care?
All people are strongly encouraged to have a primary care doctor. If you have a medical condition that requires medication or regular doctor visits, you will need to have a primary care provider. At Northwest Metabolic Medicine, we do not provide primary care or manage any acute issues (such as colds/flu, infections, annual exams, injuries, etc.). We will work in consultation with your primary care provider, and we are happy to help you find a primary care provider if you need one.
Will I lose weight?
I want to be clear, that my primary goal is not your weight loss. However, you will almost assuredly lose weight over time…that is not even really a question. But my initial focus will be to get you healthier and feeling better.
Will Dr. Geidl prescribe medications for me?
Many of my patients achieve success without using any medication. That being said, every patient situation is different. Medications can be appropriate and helpful for some people. During your visits, I will discuss your options, and what tools, including medication, could be used on your road to wellness.
Does Dr. Geidl recommend vitamins/supplements?
I am convinced that some vitamins and supplements play a role in becoming healthier, and many patients will benefit from limited supplementation. Certain health conditions that I test for can be treated successfully with specific vitamins or supplements. During your visits, I will discuss which of these may be right for you.
Do you treat children?
I am only accepting new patients who are age 18 and over.
Do you take care of patients who want or have had bariatric surgery?
Yes. Although Dr. Geidl is not affiliated with any bariatric surgeons, she has the capability and training to assist with pre- and post-bariatric surgery patients and conditions.
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