FAQ on the costs of treatment
Q. What will be the cost of my consultation(s) with Dr. Chen?
A. Due to concern for possible collusion, current costs are not
posted on this website. Please contact the office directly at
831-462-6013 for current fee structure. All new appointments run
1.5hrs. long, and return visit appointments are 1hr.
Follow-up appointments are generally within 3-6 months, and at a
minimum of every 6-12 months, depending on the complexity of
each individual patient's medical situation, in order for Dr.
Chen to continue authorizing prescription refills, and provide
the best medical care. Follow-up phone appointments (for those
who require a long commute to the office) are charged at the
same rate as in-person appointments. Please refer to my office policy section
for more details.
Q. Does Dr. Chen take insurance?
A. No, Dr. Chen does not bill insurance. In addition, she is a
medicare opt-out physician, and legally, none of her services
may be billed to medicare for reimbursement. Payment is due in
full by cash, check, VISA, or Mastercard at the time of
services. Patients will receive a receipt (superbill)
documenting payment for services received. This receipt includes
ICD-10 CM diagnoses codes, CPT procedure codes, dollar amount
paid, and Dr. Chen's tax ID information, so that the patient can
then submit this to his/her own insurance for possible
reimbursement, or apply towards a deductible, or towards a
health savings/flexible spending account. For patients who wish
to have their visit pre-authorized by their insurance before the
office visit, the CPT code for a 1.5-hr. new patient visit is
typically 99205. The ICD-10 CM diagnostic code is typically
N95.1 for menopausal symptoms, and additional diagnostic codes
pertaining to the individual patient may vary. Reimbursement is
unlikely if the insurance is an HMO plan (examples include
Kaiser, Health Net, Pacific Care, and other HMO plans, as Dr.
Chen would be considered an out-of-network provider). Please
refer to my office policy
section for more details regarding potential reimbursements
based on your insurance coverage.
Q. What is the cost of my prescriptions?
A. This will vary depending on your treatment plans. Low dose
FDA-approved bio-identical hormone products such as patches,
gels, creams, and pills will typically be covered by major
insurance plans if prescribed around the time of menopause, and
therefore, the patient's cost will depend on each individual's
co-pay plan. Bio-identical hormones specifically compounded by a
compounding pharmacy are typically not covered by insurance, and
the cost will depend on each pharmacy's price.
Q. What is the cost of lab work?
A. This will vary depending on your treatment plan, as well as
how much recent testing may have already been done by your
previous physician(s). Dr. Chen usually requires baseline labs
to be done in someone with symptoms but no previous evaluation
or incomplete testing. Blood testing is preferred, and the
extent of testing depends on each patient's medical situation,
i.e., it could be as simple as sex hormone levels, or as
complicated as someone requiring extensive testing to include
adrenals, nutritional status, gut health, thyroid, pancreas, and
pituitary hormones evaluation. Most reputable labs offer a
cash pay discount if lab work is paid at the time of service, so
you'll need to check with individual labs near you. Dr. Chen has
accounts both at Quest Diagnostic Labs and LabCorp, but her
generic lab requisitions are valid at any licensed laboratory.
Patients who have HMO insurance plans (examples include Kaiser,
Health Net, Pacific Care, or other HMO plans) will need to pay
out-of-pocket for any labs ordered by Dr. Chen, unless they are
working with a primary care physician within their specific HMO
plan who is supportive and will order the requested labs for the
patient. HMO plans, by design, try to keep all expenses
within a system of contracted providers, for cost containment
purposes; hence will typically not cover expenses incurred as a
result of seeing an out-of-network provider.