FEMM is proud to offer an affordable and convenient way to access medical care. We are committed to providing you the highest standard of care and working together to find the payment option that best fits your individual needs.
FEMM Telehealth accepts most insurances. If you do not have insurance, are out of network, or use a health share plan, please see below for our self-pay discounted rates. We will bill your insurance company for your medical services. Your patient account will be billed all copay, coinsurance and/or deductible amounts in accordance with your insurance plan’s claims determination. Your coverage and patient liability will depend on your specific insurance plan, your policy, and your specific benefits. Please see below for our policy regarding copays, coinsurance and deductibles.
Please view the list of in-network insurance plans on your provider’s scheduling page. Insurance enrollments are specific to each provider. If your insurance is out-of-network with the provider you wish to see, it may be less expensive for you to use our discounted self-pay rates. You can also contact our billing department at [email protected] to check your particular plan.
After your appointment, you will receive a bill in the mail (unless you have opted for E-statements). You may pay your balance on your patient portal or via Athena QuickPay. If you have an outstanding balance, you may also receive email, phone and text reminders. If you are having trouble paying your bill after your insurance has processed the claim, please contact our billing department through your portal or at [email protected]. We will speak with you personally and work out a financial solution.
If your insurance company is “out-of-network” and you still want your insurance to be billed, we can attempt to bill your insurance at your “out-of-network” rates for an office visit. Some plans do not include “out-of-network” benefits, so this may not be an option for all patients. Medicaid plans outside the state of OH or MI cannot be billed, and patients with Medicaid-OH or MI will need to see a provider who is credentialed with their plan.
Please call your insurance company using the number on the back of your card to verify if one of our providers will be in-network for your plan.
We are unable to bill BCBS HMO plans as we are not in-network. If your plan is an EPO or tiered plan, we will be considered tier 2 or tier 3 depending on your plan. Our billing address is located in Ohio, so if you are in another state and your plan does not cover non-emergent/urgent services outside your state, then your insurance will deny the claim.
Please keep in mind that benefits are subject to plan coverage at the time of service, and may change. Furthermore, they are not a guarantee of payment or coverage. We encourage you to double check your benefits yourself through the customer service phone number located on the back of your insurance card. We have providers in many different states, with varying insurance coverage. Most claims will be submitted under full-level providers, even if you are seen by a midlevel (PA, NP, CNM, etc.). See below for which full-level provider your claim will be under based on your state:
Dr. Danielle Koestner, DO: AL, AZ, CO, FL, ID, IN, KS, KY, LA, MI, MN, MS, MO, MT, NE, NV, NM, ND, OH, OK, RI, SD, UT, VT, WA, WI, WY
Dr. Karen Poehailos, MD: CT, DC, GA, IL, IA, ME, MD, MA, NH, NJ, NY, NC, PA, TN, TX, VA, WV
Medicaid-OH patients: you will need to schedule all appointments with Maureen McCarthy, NP or Dr. Lindsay Rerko, DO. Claims will be submitted under Dr. Rerko.
Medicaid-MI patients: you will need to schedule all appointments with Sarah Yskes, NP, Zachary Jones, PA-C, or Dr. Danielle Koestner, DO.
Some insurance companies will cover the cost of these visits as well, but others will not. If you have Medicaid MI or OH, Anthem/BCBS, or Cigna, we can bill insurance for your appointments. Otherwise, you will be billed at our self-pay rate of $75 per session.
Our billing staff can work with you to try to obtain reimbursement from the insurance company. If our billing staff is unable to negotiate payment from your insurance, we will charge you our discounted self-pay rates.
We aim to keep our self-pay rates affordable, and we also offer payment plans and SuperBills. Our goal is to make this care accessible to all. If you believe you would qualify for an income-based discount, please contact our billing department at [email protected].
FEMM Foundation
400 Altair Parkway
Suite 3100
Westerville, OH 43082
(614) 360-9995
PO Box 16914
Belfast, ME 04915-4064
*Patients located in MI covered by Blue Care Network, Priority Health, or Medicaid-MI should contact the billing department for additional information.
Copays, coinsurance and deductibles are determined by your insurance provider and are specific to your particular benefits plan. When a claim for your visit with a FEMM provider is filed with your insurance on your behalf, your insurance provider will determine if a copay, coinsurance or deductible amount is due for the visit. This amount will be assigned to patient responsibility and automatically billed to you. You may be required to pay your copay in advance of your appointment.
Typical CPT codes: 99204, 99205
Typical CPT codes: 99214, 99215
Typical CPT code: 99404
Please note: these rates reflect our self-pay discounts and are not eligible for reimbursement from your insurance company.
In most cases the lab will bill your insurance directly. If you do not have insurance coverage for your lab work, you can request that FEMM pay for the tests and then bill you, known as “client billing.” We are unable to support retro or prior authorizations for lab work. We recommend client billing if your plan requires one. Regardless of billing method, all financial costs related to lab work is the patient’s responsibility.
Our negotiated lab rates will lower your self-pay lab bill significantly. LabCorp has the most competitive pricing and extensive testing options. We also work with Quest Diagnostics if you do not have a LabCorp near you. However, complex lab work can still cost several hundred dollars, and not all tests have negotiated rates. If you need to determine the precise cost of your labs, contact us through your patient portal, at [email protected], or refer to the Client Billing letters:
Labcorp | Quest Diagnostics
Some visits allow billing for add-on time. If your visit goes over the maximum time, your doctor may charge a code for additional time. At the self-pay rates, extended visits typically cost $20 per additional 15 minutes.
Typical CPT codes: 99417, G2212
Phone calls with your clinician that are outside of a video-based consultation may involve additional fees to you or claims to your insurance. Self-pay fees range from $85 to $200 depending on the time and level of care rendered.
Typical CPT(s): 98012, 98013, 98014, 98015
If you are advised to seek care from another organization outside of FEMM, such as Hospital or Outpatient services, the cost will not be connected to FEMM and we will not bill you for it. The external organization will be responsible for providing you with a Good Faith Estimate for their own services.
Medical Supplies, including Durable Medical Equipment and Prescription Drugs, are the responsibility of the patient. FEMM neither purchases nor bills for medical supplies.
You will be charged $25 if you miss your scheduled appointment or if you cancel your appointment less than 24 hours before it begins. This includes cancellations due to the patient not being physically located in a state where the provider is licensed at the time of the visit, even if temporarily (for college, holidays, or other reasons). These fees, policies, and cancellation windows should be considered prior to making an appointment.
No Surprises Act: In compliance with the Consolidated Appropriations Act (“No Surprises Act”), the above information reflects a good faith estimate for final charges after our self-pay/uninsured discounts have been applied.
In compliance with the No Surprises Act, FEMM is required to provide certain patients with a Good Faith Estimate. You are not required to obtain a Good Faith Estimate. Much of the same information is found in our Discounted Self-Pay Rates section above. To receive the Good Faith Estimate provided for you, please contact our billing department through your patient portal or at [email protected], and your Good Faith Estimate will be emailed to you.