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Insurance Plans and Payments


 

Our office does not accept any insurance plan directly. We will provide you the coding needed for you to apply for reimbursement from your insurer, but recognize that they don’t want to pay often, and especially not for chronic pain management or other expensive medications or treatments.

We do not accept Medicare, Oregon Health Plan, Workman’s Compensation, etc.

Medicare will not allow you to bill them for services we provide you.

Oregon Health Plan
, depending on which organization services it for you, decides what they are willing to pay for, but they announced that they will eliminate most chronic pain management services as of January 2019.  If you can get on any OHP plan run by another CCO besides Umpqua Health Alliance, you will be doing yourself a great service.

Workman’s Comp
 is not really interested in getting you better; they just want to get you back to work after denying multiple forms of treatments and medications. They would like you to exhaust your own personal bank account so that you are forced to return to work out of sheer financial necessity. They are uncooperative and difficult to work with. These are just some of the many reasons that most providers do not accept Workman’s Comp patients.

We have priced our visits to be affordable and have found that we are far cheaper than all other pain specialists in the area, especially for the actual face-to-face time you get with Dr. George and not some Nurse Practitioner or Physician’s Assistant that bills you at the physician’s rate of care.

We expect full payment for services rendered at the time of your visit. New patient visits for pain management or primary care are pre-paid. New or renewing OMMP visits are also pre-paid. We do this because of the length of the appointment and to prevent patients from failing to show up for their scheduled time.  When you fail to show up for a pre-paid visit time, you will lose your payment credit due to our lost time that we could have been seeing someone else during the slot you reserved.

We will provide you with billing codes if you want to submit your bills to your insurance company to try to get reimbursement.  Some patients have success with that, while others give up after seeing the unnecessary delays and trouble that insurance companies create when billing them.  Despite our forms clearly stating that all reimbursement payments should go directly to the patient, some insurance companies still wrongly send Dr. George the payment which he has to refuse to deposit and tell them to do their job properly.  They demand and want things, just because they feel all powerful and such.  They’re not used to providers, like Dr. George, refusing to work with them and questioning their actions.

Some insurance companies demand that Dr. George provide the with his TIN (Taxpayer Identification Number) for reimbursements.  Dr. George has to remind them that they are to pay the patient, not Dr. George.  They argue, so Dr. George sends them his contractual agreement form that he created to deal with their demands, then amazingly they don’t need his TIN anymore!

Years ago a study was done involving Fortune 500 CEO’s.  They were asked to review the insurance contracts that all doctors get forced to sign to be able to “participate” in their preferred provider networks.  Every single one of the CEO’s said they would NEVER sign such a contract; everything was in the insurance company’s favor, not the patient’s or the doctor’s favor.

Some insurance companies also ban providers (gag orders) from discussing certain treatments or medications with patients all because of cost issues; they don’t want to pay for them, despite the fact that the provider may feel it is the best treatment for the patient.  Insurance company employees are not medically trained.  Even if a medical review officer sees the chart record, they still have not met or examined the patient in person.  Yet they still will deny care based on their “opinion” and policies.  It’s all done to save them money; they don’t care about patient health or quality of their lives.

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