Insurance Information

These are the main insurances we do and do not accept*.   We try to keep this information up to date however, if you do not see your carrier listed, please inquire when you make your first appointment because this list changes often.

We do accept the following:

 

Allways Health Partners

Blue Cross/ Blue Shield
Tufts
Harvard Pilgrim
Aetna
Cigna
Medicare
United Health Care
Fallon
Tufts Medicare Preferred

We do not accept the following:

Any Medicare Replacement HMO plans except for Tufts Medicare Preferred

The United Healthcare Medicare Product (AARP medicare complete)

Tufts Network Public plans
United Medicare Advantage
Aetna Medicare Advantage
BC/BS Medicare Advantage HMO

*Some medical services, as well as alternative services that our practitioners provide, may not be covered by your carrier or policy.  Please review your policy for specific coverage.

Insurance Referrals

Inner Balance is part of Partners Health Care Organization.  We feel this organization offers the ‘best of the best’ in both primary care physicians, hospitals and specialists.  Dr. Bordiuk and Associates are required to refer only within this network for HMO insurance referrals and are not able to give referrals outside this network.  For referral requests, please email on the patient portal or call and leave a message on our referral line. Please allow two business day for referrals to be sent out.

Co-Pays for Physicals/ "Wellness Exams"

The National Health Care Reform Law stipulates that co-payments (“co-pays”) will no longer be required for certain preventative medical services such as annual physicals. Therefore, we will not collect a co-payment at the start of the visit. “Wellness Exams” are defined as including:

• Age-and gender-appropriate history
• A comprehensive physical examination
• Discussion regarding screening tests and immunizations
• Counseling, anticipatory guidance (“what to expect”) or interventions to reduce health risks

At Inner Balance, we strive to give you the best possible care and may need to go beyond what your insurance covers as a 'wellness’ exam to best support your health and wellness. On occasion, there may be time in the appointment to 'evaluate and manage' an acute medical issue (i.e. cough or injury) or a previously diagnosed, chronic health condition (i.e. hormonal imbalance, hypertension or insomnia.)

If this is the case, we will bill your insurance using an ‘Evaluate and Manage’ code in addition to the ‘Preventative' visit code. In this case, a co-payment will be required and billed to you after, along with any deductible or coinsurances that apply.

For the most part, our patients appreciate that the amount of time booked for a physical/wellness exam can allow for further 'evaluate and manage' care. However, if this is not the case for you, please let both the front desk staff and your practitioner know that you prefer or need the visit to stay within the confines of a 'wellness visit.'

Other services performed at the time of the physical, such as blood work, EKG, and urinalysis may or may not be considered by your insurance as part of a ‘preventative' service. These may generate additional costs in the form of a deductible and/or co-insurance. It is the patient’s responsibility to know what their individual plan covers and does not cover.

Please call your health plan if you have questions regarding your benefits..

Scheduling

Our scheduling process allows enough time for each patient to have a thorough visit with our care providers and we run on time. We do not spill over from one scheduled appointment into the next.

We want you to enjoy the full benefit of your scheduled visit and ask that you please be on time for your appointment.