Can I Use My Insurance
We don’t take insurance because insurance companies won’t let us practice medicine the way we want to do it. We want to be able to offer a vasectomy procedure in a single visit and insurance companies won’t reimburse unless we require our patients to come at least 3 or 4 times to the clinic. Most insurance plans will require that you make an appointment one day for a pre-surgery consultation, a second day for the surgery, and a third day for a follow-up. Then they require you to come back to the clinic for a semen sample. By not taking insurance, we can offer you the convenience of taking off from work for only one day.
We offer a cash price of $680 and a single visit to the clinic. If you have health insurance and you believe it might cover part of the expense of a vasectomy, your insurance company can walk you through the process of filing an out-of-network claim and we also have detailed instructions—just mention to us that you would like to receive printed instruction and a detailed receipt. When you are ready to file, call the number on the back of your insurance card. Your particular insurance policy will determine whether or not the policy will cover some of the expense. Any reimbursement of your cost will be between you and your insurance company. We will not remain involved to receive any of the insurance reimbursement because you have already paid us in full.
Here’s how it works at our clinic: We collect a non-refundable $100 from you to book the time slot and then the $580 balance for the procedure is due on the day of the surgery for a total cash price of $680.
At Gentle Procedures, $680 is all you will pay for your vasectomy with the advantage of the no-needle, no-scalpel, open-ended technique and faster recovery, in-and-out of the clinic in less than an hour. If you want the best service and the most comfortable procedure possible, it’s a price worth paying.
If you’re thinking, “But I want to use my insurance”, when you start to looking at the numbers if you choose another provider, you may be surprised to find there is no advantage to using your insurance for your vasectomy. That’s because, if you were to go to another provider who charges more but takes insurance, your out-of-pocket cost required by your insurance policy might end up being the same as our cash price. Your insurance carrier determines your portion of the responsibility, and often, with copay, co-insurance, and deductible, the patient portion comes out being about the same as our $680 cash price.
If you want the convenience of a single visit to have the procedure done by the no-scalpel, no needle method, by a physician who specializes in vasectomies, ours is a price worth paying. Look at it this way – $680 is less than the price of a new set of tires for your car and it’s only a one-time expense! Or it’s about the price of a week’s worth of groceries for a family of 4.
Why Don’t We Accept Health Insurance?
It’s not easy for a small, independent clinic to deal with insurance companies. Most people do not realize that insurance pays about 50 cents on the dollar charged or doesn’t pay at all or takes back the payment months later. That makes it very difficult for independent medical practices to remain viable.
It has been our long experience that, prior to the surgery, health insurance companies often provide inaccurate information regarding an individual’s coverage for a procedure and how much a patient may owe. After the procedure has been completed, it is not unusual for health insurance companies to inform the physician that the information they provided during pre-verification was inaccurate. For example, prior to the surgery, it is not unusual for the agent to say a person is fully covered and give us a specific amount he has to pay. Several weeks after the procedure, the insurance company will then tell us they made a mistake, the procedure was not covered and the patient needs to pay more co-insurance.
Our office is then put in the awkward position of having to contact the patient and ask for more money. By then, our patients are long-gone and often these calls are not well received. We end up in the middle of the patient and his health insurance company and the health insurance companies try to distance themselves from the problem they caused because their staff provided inaccurate information. In this scenario, when we send the patient a statement, because the surgery is a “one-and-done” procedure and we never see the patient again, the patients often simply ignore the statements we send. Our office is then required to take the loss…even though we had nothing to do with the confusion.
We consistently have good reviews from patients. When we do have dissatisfied patients, it is because their health insurance company has provided inaccurate information and we had to become “the bad guy” to try and collect payment from the patient who believes we are being unfair. These patients often unfairly blame our office for the mistakes or delays by their health insurance company.
If You Want To Use Your Health Insurance
If you have health insurance and you want to use it, it's not that complicated to file your own insurance claim. In fact, because you are the customer and we are not, the insurance companies often deal more quickly with you, the policy holder than they would with us. If you want to file a claim, we will give you extensive instructions for how to file a claim for an out-of-network provider. If you call the phone number on the back of your insurance card, a representative can also walk you through the process.
If your policy does cover the procedure and if your insurance company does have a reimbursement, that money will come directly to you and not to us as a billing provider.
Call Us to Book!