Health and Wellness of Carmel is not a traditional doctors’ office. We are a physicians’ office that specializes in holistic and functional care. This specialization routinely includes services, procedures, and products that are not covered by insurance plans.

Insurance companies consider these various components alternative or complementary medicine and, as such, do not provide benefits. Many times, this determination is made by their Medical Director and typically does not vary across companies. Thus, it is very important you call your insurance company and understand the benefits provided.

We try very hard to file every claim with your insurance company as directed in our contract with them. It is mandated we utilize certain codes and nomenclature when billing them. However, the American Medical Association provides the Current Procedural Terminology (CPT) codes for our use. There is no CPT code for many of the different holistic and functional medicine procedures we utilize. Therefore, when we attempt to file your claim through the electronic clearing houses most insurance companies use, our claims are rejected by the system due to lack of the proper codes. Again, as there are no codes established, it is impossible to receive payment for services rendered but we do make that attempt on your behalf. It is paramount you understand what benefits your insurance company provides for you as you will be responsible for this fee. We are permitted by our agreement with most insurance plans to bill the beneficiary of the plan for any non-covered services.

We will file a claim with your insurance for every service and product that is covered by your plan. However, our care for you includes several services and products that are not covered by your insurance. We will not prepare a claim for your insurance company and will not file a claim with your insurance company for these non-covered services and products. The non-covered services and products are the financial responsibility of the patient and payment is anticipated at the time of service.

Services, procedures and products not covered by insurance include but are not limited to:

• Physician Grade Supplements
• Specialty Lab Testing and Procedures (i.e. Heavy Metal Testing, Bio101, IV Therapy… etc.)
• Holistic Functional Assessments (Functional Fee)

We also have an independent phlebotomy lab on-site for patient convenience. This lab is not affiliated with Health and Wellness of Carmel and remains independent. Insurance claims and patient billing are conducted by LabCorp. Patients will receive billing directly from LabCorp. and not from Health and Wellness of Carmel.