Our office is considered ‘in network’ with the following insurances only:
- Medicare (traditional only-not Advantage plans)
- BCBS (Traditional, PPO, & Federal Employee program only)
- Priority Health (most plans-will have to verify)
If you have an insurance other than what is listed above, we will most likely be considered ‘out-of-network’:
- This means that you will likely be paying the office out-of-pocket at each visit. At your first visit, as a courtesy, we will submit a claim to your insurance for you. Then, if services are approved and payable, they can reimburse you directly.
- If your insurance will not pay, you will be considered a cash paying patient and will be eligible for a 15% cash discount.
- Medicare Advantage plans are the most complicated. In this situation, each Advantage plan is different and we will likely need a deposit from you on the first visit until we know exactly how much your plan will pay for our services. This process can be lengthy and is not under our control. The deposit acts as a down payment for services. Our billing department will work with you to ensure that your claim is handled. IF your insurance pays, the deposit will then be applied to your future copays, deductibles, etc.
NO INSURANCE: Self-Pay’ pricing. 15% discount on services.
- Costs will be based on services provided and billed upon completion of the appointment.
- Average costs for a New Patient visit with OMT are between $250-$320.
- Average costs for Established patients with OMT range from $150-$250.
- Payment is required at each visit. If you have an outstanding balance, you will not be allowed to schedule your next visit until your account is up to date. HSA, FSA, credit card, check/cash (preferred) are all accepted.
NEWBORN/CHILDREN:
Welcome to this world, baby! We want to give every infant the best start in this new world, so their first treatment for a newborn (under 6 months old) is free! Depending on insurance coverage, special discounts programs are available for older children.
VETERANS AND FIRST RESPONDERS:
Thank you for your service! If you are in this population and we do not accept your insurance, please call the office for a specialized pricing plan so you may get the care you deserve. Please let our scheduler know and you will be eligible for priority scheduling.
Missed appointments:
The online patient scheduling system is meant for easy scheduling for you. You will also receive reminder texts and emails. A missed appointment without advanced notice does not allow for another patient to benefit Dr Gruber’s time. If you need to reschedule or cancel your appointment, please do it at least 2 business days prior to your current appointment time. If this is not done, you will be charged a ‘no show’ fee of $100.00 for a new patient appointment and $50 for established patients.
We always suggest that you contact our billing department regarding Dr. Gruber’s participation with your insurance, estimated costs, or any other questions you may have by emailing them using the below form or call/text 586-495-9591. Thank you!
Our office is considered ‘in network’ with the following insurances only:
- Medicare (not Advantage plans)
- BCBS (Traditional, PPO, & Federal Employee program only)
- Some Priority Health plans (contact Priority to verify your particular plan)
We always suggest that you contact your insurance to verify Dr. Gruber’s participation at this location with your specific plan and what your responsibility will be for our services. Our most common services are a specialist office visit and osteopathic manipulative treatments (OMT). Example billing codes for these services are 99204, 99214 and 98929.
If you have a different insurance other than what is listed above:
We will most likely be considered ‘out-of-network’. However, you may still have out-of-network coverage that may cover some services at our office.
As a courtesy, we will submit a claim to your insurance for your first appointment. Until we find out what your insurance will cover, a $250 deposit will be required at your first visit.
If you end up having some coverage, the deposit will then be applied to your future co-pays, deductibles, etc.
If the service(s) are not covered, you will be considered a ‘Self-Pay’ patient going forward. Note, you may have an additional balance for your first appointment if nothing is covered.
No Insurance/‘Self-Pay’ pricing:
- Costs will be based on services provided.
- Average costs for a New Patient visit with OMT are between $250-$350.
- Average costs for Established patients with OMT range from $150-$300.
- Payment is required at each visit. If you have an outstanding balance, you will not be allowed to schedule your next visit until your account is up to date.
If you have a newborn/infant and children:
Welcome to this world, baby! We want to give every infant the best start in this new world, so their first visit consultation/treatment for a newborn (under 6 months old) is free! Please contact the office for special discounts for children.
Veterans and First Responders:
If you are in this population and we do not accept your insurance, please call the office for a specialized pricing plan so you may get the care you deserve.
Missed appointments:
The online patient scheduling system is meant for easy scheduling for you. You will also receive reminder texts and emails. A missed appointment does not allow for another patient to benefit Dr Gruber’s time. If you need to reschedule or cancel your appointment, please do it at least 2 business days prior to your current appointment time. If this is not done, you will be charged a ‘no show’ fee of $100.00 for a new patient appointment and $50 for established patients.
If you have any other questions, feel free to fill out the form below and someone from our office will respond to you:
