Insurance Coverage

Please verify insurance coverage before scheduling your visit. You can do that by calling your insurance company or going on your insurance company’s provider directory and verifying that the following providers are covered on your plan:

Group Tax ID (EIN/TIN): 27-3741565

  • Elias Kass, ND, NPI 1245546100

  • Ankith Donthi, ARNP, NPI 1871139162

  • Samantha Kunze Garcia, ARNP, NPI 1679158448

If you have an out-of-state plan (see below), you must also verify that they cover services provided by a naturopathic physician.

We cannot verify benefits for you. You must verify benefits for yourself. Each company has dozens of plans, so it’s not as simple as “do you take Premera?”

Commercial Plans

Search in your plan’s provider directory to verify our providers are IN NETWORK. Both providers are in network (contracted) with most commercial plans in Washington, including Regence, Premera/Lifewise, First Choice (including Kaiser PPO), and Aetna.

Accountable Health Networks/Accountable Care Networks often have very small networks. Talk with your plan to understand whether or not we are covered, or use their directory to look us up.

If you purchased your plan through the Marketplace (Washington Healthplanfinder), please confirm that your provider is listed as a primary care provider (PCP) on your plan -- Molina Cascade plans should be fine, but we may not be in network with UnitedHealthcare Cascade plans, Ambetter Cascade plans, CHPW Cascade plans, etc.

We are OUT OF NETWORK (not contracted) with Cigna, Kaiser Core (also known as HMO) and TriCare.

Medicaid/Apple Health/DSHS

Our providers are contracted with DSHS (open coupon), Molina, Amerigroup, Coordinated Care, and Community Health Plan of Washington (CHPW).

For primary care, we ask that you make Molina your Medicaid plan. If you would like to change your Medicaid plan, you can do so through WAProviderOne.org. CHPW does not permit providers outside their facilities to be listed as PCPs.

UnitedHealthcare Medicaid plans are a dicey proposition. Please call the number on your card and double check coverage. Generally plans administered by NPN, HMSO, etc, do not cover NDs.

Out of State Plans

Some employers use plans based in other states, for example, BCBS-IL is based out of Illinois. These plans often use a local plan to process the claim, and they often use a network that includes our providers. However, even though the local plan processes the claim, the actual plan follows the laws of the state where it’s based, and they are not subject to Washington laws.

In our experience, BCBS-MA and BCBS-NY will NOT cover services rendered by a naturopathic physician.

If you are seeing our clinic for anything other than behavioral health services with Ankith Donthi ARNP, you MUST verify that your plan will cover services rendered by a naturopathic physician, and does not exclude services rendered by a naturopathic physician. If the plan pays but later realizes that the services shouldn’t have been covered, they will take back the payments and you will be responsible for the costs. Because vaccines are billed under the provider present in the office that day, and primary care patients may be seen by any available provider, this requirement applies even if you are seeing our ARNP for primary care or are coming here for vaccines only.

Health Share Plans

We are happy to provide invoices for health care cost sharing plans, just let us know what you need.

SUGGESTED QUESTIONS TO ASK YOUR INSURANCE COMPANY

  • Does my plan cover naturopathic medicine or services rendered by a naturopathic physician? This is especially important if your plan is not based in Washington State. NY plans will almost certainly NOT cover our services.

  • Does my plan exclude naturopathic care?

  • Is my provider a preferred (in network) provider?

  • Is my provider designated a primary care provider or a specialist?

  • If they are not in network, do I have out-of-network coverage? How will my care be covered out-of-network?

  • Do I need a pre-authorization? Do I need a referral?

  • Do I have a deductible, and how much is remaining?

  • At what percentage will my insurance cover my care? What is my co-insurance?

  • How much do I pay at each visit (co-pay)?

  • What are my preventive benefits?

Related

The curious case of billing for well child visits, or, why did I get billed for that?!