Understanding the Cost of Your Care

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We know that cost matters.

One of the most common questions we hear from patients is, “How much is this going to cost me?” We understand. Healthcare costs can be confusing, particularly when you are dealing with insurance deductibles, copays, coinsurance, and services that insurance companies may not cover. At MDBI, we make every effort to provide you with an estimate of your expected out-of-pocket costs before you begin your evaluation and treatment. Our goal is for you to understand the potential financial responsibility associated with your care before you receive it. Because every insurance plan is different, we cannot guarantee exactly what your insurance company will ultimately pay. However, we can explain our charges, identify services that may not be covered, and provide you with the best estimate possible based on the information available to us.

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Your Initial Evaluation

Our initial evaluation is approximately 3½ hours and is significantly more comprehensive than a typical office visit. The majority of our evaluation is typically submitted to insurance. However, there are some specialized services that insurance companies may not cover.

This can happen for several reasons:

• Certain CPT codes may be considered experimental, investigational, or non-covered by an insurance plan.

• Some of the specialized testing we perform does not currently have a specific CPT code.

• Individual insurance plans may have exclusions or limitations on particular vestibular services.

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What is the most I could pay for an Evaluation?

The maximum out-of-pocket cost for a complete initial evaluation at MDBI is $1,395. This is a maximum—NOT what most patients pay. Your actual out-of-pocket cost may be considerably less depending on your insurance coverage, deductible, copay, coinsurance, and the services your insurance company agrees to cover. We provide an estimate prior to testing.

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What About Treatment?

Following your evaluation, we develop a treatment plan based specifically on your individual diagnosis. Our therapy is highly specialized and individualized. MDBI utilizes different treatment techniques that are not available in traditional physical therapy or vestibular rehabilitation settings. We are also actively involved in clinical research and the continued development of specialized approaches to vestibular assessment and treatment. There are very few facilities in the United States offering a comparable combination of comprehensive vestibular assessment and specialized treatment.

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How Many Therapy Visits Will I Need?

Most patients will require ~7–14 therapy visits, although this varies considerably based on diagnosis, severity, treatment response, and individual needs. A therapy visit has a minimum charge of ~$240 before insurance benefits are applied. Your insurance may cover a significant portion of this cost. Your actual responsibility will depend on your deductible, copay, coinsurance, and the specific services covered by your plan. Some of the specialized services incorporated into our treatment do not have an applicable CPT code or are not covered by insurance. These services may result in an additional out-of-pocket charge that is NOT billed to insurance, generally $50–$100 per therapy visit, depending on the services provided and the insurance plan. An estimate will be provided.

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Why Doesn't Insurance Cover Everything?

Insurance companies determine what they will reimburse based on their own medical policies, coding systems, and coverage rules. Unfortunately, insurance coverage does not always keep pace with advances in specialized vestibular testing and treatment. A service being non-covered by insurance does not mean that the service is medically unnecessary or that it does not provide value to your care. In some cases, the technology or specialized treatment simply does not fit within the insurance company's existing coding or coverage structure. Our philosophy is to provide the most comprehensive assessment and treatment we believe is appropriate for your condition—not to limit your care solely to services that happen to have an insurance-covered code.

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Payment Options:

We require everyone to keep a active credit card on file for cancellation fees and balances. Cancellation fees and No Show fees will automatically process. For any balances on your account, you will be notified via text or email 24 hours before your credit card is run. We do NOT offer payment plans at this time, but we do offer Care Credit with 12, 18, and 24 month options with NO interest fees.​

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Our Commitment to You

We don't want cost to be a surprise. Before you begin care, we will make every effort to explain:

• What services are being provided

• What we expect to submit to your insurance

• Which services may not be covered

• Your Estimated out-of-pocket responsibility

• Any additional charges you should anticipate

 

Please remember that our Estimate is not a guarantee of insurance payment. Your insurance company ultimately determines how claims are processed and what portion of your care is your financial responsibility. Our goal is to provide exceptional, highly specialized vestibular care while being as transparent as possible about the cost.

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