Insurance Billing

Dr. Musnick is an out of network provider, so charges for his time are due at the time of service. We do bill PIP (Personal Injury Protection) insurance for auto collisions, as well as L&I and self insured insurance for work-related injuries. You can find more information on MVA and L&I coverage here.

Why is Dr. Musnick out of network in regard to private insurance? 

Dr. Musnick has decided that it is more important to spend extra time with his patients rather than seeing a higher number of patients each day.  He uses this time to take an expanded history, physical exam and develop treatment programs for new patients. He uses standard procedure codes and standard diagnostic codes for his visits.

Why see Dr. Musnick if you will have to pay at the time of the visit?

Dr. Musnick is very experienced in the fields of Sports Medicine and Functional Internal Medicine.  You will learn a lot about your condition and what may be done to help you. Just one visit may give you more information on your condition in regard to diagnosis or what tissues are causing problems in your body. You will be presented with options for treatment that many physicians do not offer.  Dr. Musnick has been in practice for 25 years. He has lectured all around the country.  He was a professor at Bastyr University as well as the University of Washington. He is a faculty member at the Institute for Functional Medicine.  He has a great deal of experience in many conditions and often takes a unique and comprehensive approach to get to the root of the problem that you have.  The time and cost spent for a first visit is well worth the expenditure. A first visit may make a significant difference in the outcome of your pain or health issue.

Did you know that you may still receive a significant bill even if you see a doctor that is “covered by your insurance?” This is because these doctors may use codes that are not actually covered.  You may end up paying a lot more for the visit that you understood was being billed to your insurance than to your visit with Dr. Musnick.

Visit Costs

For the first visit, Dr. Musnick charges $360/hour for the first hour and accordingly beyond that. He spends at least an hour with a new patient, but can often spend upwards of 90 minutes depending on the complexity of symptoms. Modalities like Frequency Specific Microcurrent are usually billed at $180 per visit, as well as 30 minute follow-ups. Other modalities such as Low Level Laser Therapy or Pulsed Electromagnetic Field Treatment may be billed from $95-150. Procedures like injections are billed at certain injection rates.  Visits without procedures or modalities are billed according to time spent and you can receive more information on all of our rates by calling our front desk.

Private Insurance & Out of Network Reimbursement 

If you have private insurance you will be responsible for payment at the time of your visit with a check, credit card or cash. If you have private health insurance you may be able to get a percent of the cost of the office visit reimbursed by your insurance company. We will provide you with the necessary forms for you to submit to your insurance to receive a partial reimbursement of the cost of the office visit.

All insurance companies have policies regarding seeing doctors that are not participating in their network.  They will usually reimburse a percent of the cost of that visit, but the percentage of reimbursement varies between insurance companies.  Reimbursement is related to how much they think a visit should cost as well as how much deductible you have. We advise you to talk to your insurance company to find out more information on how much they are likely to reimburse.

Imaging, Lab Studies, etc.

All radiology (x-ray, MRI) and basic lab studies (blood, stool work) that are ordered by Dr. Musnick will be billed to your insurance directly by the imaging or lab facility.  You are not responsible to pay for these at our clinic.

Certain Functional Medicine specialty lab studies such as food allergy tests and other special tests may be recommended and you will be informed about insurance issues regarding these tests. Sometimes there is a co-pay paid directly to the lab.