INSURANCE PARTICIPATION
Our office is ‘In-Network’ (or participates) with the following insurance plans only:
- Blue Cross Blue Shield (BCBS): Traditional, PPO, and FEP (Federal Employee Plan)
(We do NOT accept: Blue Care Network, or BCBS Complete) - Priority Health: Most plans are accepted, but coverage should always be verified in advance. (We do NOT accept: Priority Health Medicaid plans)
- Medicare: Traditional Medicare and supplemental (Medigap) plans only.
Important note regarding Medicare Advantage (Part C) Plans: As a service, we will submit claims for all Medicare patients. Please note, coverage varies significantly between plans. Some plans may offer benefits similar to traditional Medicare, while others may not cover any services provided by out-of-network (OON) providers. You may be responsible for some or all service costs if you have a Medicare Advantage (Part C) plan.
SELF-PAY PATIENTS
If you have insurance that is not listed above, we are considered an Out-of-Network (OON) provider and do not submit claims to your insurance. In this case, you will be considered a ‘self-pay’ patient. The following rules will apply:
- Payment is due at the time of service.
- We can provide you with a form that you can submit to your insurance company independently.
- Patients paying out-of-pocket at the time of service receive a 15% prompt-pay discount on all services.
Additional Information:
- Fees vary based on the services provided and are billed after your appointment is completed.
- We accept payment by cash, check (preferred), all major credit cards, and FSA/HSA cards
INFANTS & CHILDREN
Welcome to the world, little one! We believe every baby deserves the best start in life. That’s why the first visit for newborns under 6 months old is completely free.
If additional visits are needed, or if your child is over 6 months old, insurance benefits may be applied.
VETERANS & FIRST RESPONDERS
Thank you for your service! If you fall into this category and we are not in-network with your insurance, please call our office to discuss customized pricing options.
We want to ensure you receive the care you deserve. Be sure to let our scheduler know your status—you may also qualify for priority appointment times, if needed.
MISSED APPOINTMENTS
We understand that life happens, but missed appointments without notice prevent other patients from accessing care.
You’ll receive appointment reminders via email, text, or phone call. If you need to cancel or reschedule, please notify us at least 2 business days in advance.
Late cancellations or ‘no-shows’ will incur the following fees:
$100 for new patient appointments $50 for established patient visits
Questions? Contact our billing department using the form below 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:
