Insurance Information
Which insurances are accepted at WholeHealth New England?
We generally ask for payment at the time of your visit. We will provide you with a receipt which you can send into your insurance. Although we do not guarantee reimbursement, many PPO and POS insurance plans with out-of-network benefits will reimburse a portion of the visit. Dr. Rothfeld is not a BC/BS provider, however, the other providers in the office do accept BC/BS.
Dr. Rothfeld also does not accept Medicare, and Medicare will not reimburse for his visits.
In addition, Dr. Levitan and Dr. Chernack are HMO providers for Tufts and HMO Blue. A referral from your Primary Care Provider is necessary to see these physicians.
At other physician offices, I pay a small amount, $10 or $15 dollars, and the insurance covers the rest. Will this be the same?
That arrangement is for in-network providers only. WholeHealth New England providers are out of network. That means, you will be expected to pay for the visit at the time of being seen. If your insurance has out-of-network benefits, we will send in the claim for you and you will be reimbursed a percentage by your insurance, after a deductible is met.
Which services will be covered at WholeHealth New England?
That varies with your insurance. Generally, office visits are covered for the most part, after a deductible is met. This depends on the type of insurance, however. You will be responsible for any co-insurance. Acupuncture benefits are available with some insurances; call your insurance if you think this may be the case. Otherwise, acupuncture is not a covered service. Osteopathic Manipulative Therapy (OMT) by Dr. Foley is covered by some insurances; please check with the staff at the time of making the appointment. Most other services such as nutrient infusions, chelation, or hyperbaric oxygen therapy are not covered. Nutritional and herbal products are generally not covered under pharmacy benefits.
Will you bill my insurance for me?
We will submit claims to all insurances which we accept. You will be responsible for any portion of the claim not reimbursed by your insurance. At the first visit, you will be expected to pay for the entire amount, so that we can be assured that any deductible will be covered. We will submit that claim and, if your deductible has already been met, the insurance will refund your money. You will be responsible for portions of the laboratory bills that your insurance does not cover. Once we are clear that your insurance covers the office visits, we will generally bill the insurances directly.
Does Medicare cover my visits?
Dr. Rothfeld is not a Medicare provider. At the first visit with Dr. Rothfeld, you will be asked to sign a waiver stating that you will not submit Dr. Rothfeld’s bills to Medicare. This is in compliance with federal legal guidelines.
If you see one of our other providers, Medicare will cover your office visits, after a deductible is met. Medicare does not cover acupuncture, vitamin infusions, chelation, or hyperbaric oxygen therapy. You will be expected to pay for these services. Medicare pays for most laboratory tests, but certain of the specialty nutrient tests might not be covered.
Does Blue Cross / Blue Shield cover my visits?
Dr. Rothfeld is not a BC/BS provider, and services provided directly by him might not be reimbursed. You will be expected to pay for these services at the time of the visit. Anne Easthope, our Nurse Practitioner, and the other providers at WholeHealth New England are BC/BS providers. BC/BS will cover your visits to them, after a deductible is met. BC/BS does not cover acupuncture, vitamin infusions, chelation, or hyperbaric oxygen therapy. You will be expected to pay for these services. BC/BS pays for most laboratory tests, but some of the specialty nutrient tests might not be covered.
If there are additional questions, call our Billing Manager, Paul Tabachnik, at 781-641-1901 ext 343.