Practice Model and Pricing

Dr. Biggee holds a license to practice medicine in MA and NH, serving patients residing in those states at this time. Dr. Biggee’s primary focus is to partner with those who have inflammatory or autoimmune disorders but welcomes those who wish to optimize health or prevent those disorders from taking hold.  Many individuals experience multiple symptoms for years without a known diagnosis.   Dr. Biggee’s goals are to guide patients in the right direction, get to the root problems, and maintain a partnership to support the health journey.  

Lifestyle and Integrative rheumatology operates as a direct care, out-of-network practice. This model is a direct relationship between the patient and Dr. Biggee.  It removes the middleperson such as insurance, referrals, hospital systems, and third parties.  Insurance company contracts dictate what services are allowed or “covered”. In a holistic health model, insurances often limit the quality and time needed to fully customize care. For this reason,  Dr. Biggee chooses to directly contract with the patient.  This allows for extended time, personalized care, and extended clinical support without hassle or restrictions from  insurance plans.  Patients have  a direct relationship,  direct access, direct communication, and direct transparent cost for truly integrated services.  

First, schedule a free discovery call for an educational session about the practice by filling out our secure contact form. No direct medical advice is given and this call does not constitute a physician patient relationship.   Second, book a one-time initial new patient consultation package.  This includes a 60 minute face to face consultation with Dr. Biggee, a comprehensive Lifestyle and Integrative Rheumatology assessment, and a 30 minute follow up with option to join a membership plan. The initial new patient initial consultation package is separate from and required prior to signing up for a membership. Third, sign up for a 12 month membership for ongoing comprehensive and supportive care.

After an initial new patient consultation, a membership plan is available for those who would like to continue services and support.  A membership model is required to book follow-ups at this time.  This guarantees direct access and direct communication to Dr. Biggee’s  personal care.  For the best outcome; frequent visits, prolonged visits, frequent communication, and ongoing support are needed.  Membership is a partnership

Dr. Biggee does not participate with any commercial insurance plans, instead she contracts with you directly. This allows for the necessary time and treatment plans it takes to provide truly integrated care.  The practice does not submit any claims or bills to insurance companies. The practice can provide a super-bill for the initial appointment for patients to submit to their commercial insurance company but the practice does not assist in submission or claims resolution.  Please see Rembursify that may help patients navigate.  The practice does not  guarantee that any insurance plan will reimburse.

This membership is not an  insurance plan and the practice strongly recommends all patients maintain active insurance to cover catastrophic care, hospitalization, labs, diagnostic testing, and pharmaceuticals.  The practice requires  insurance information on file to be accurate and updated for regulatory reasons, direct patient contracting, and medication prior authorization needs.

Those with medicare may become a patient but only by entering into a separate private direct billing contract with Dr. Biggee.  Dr. Biggee has “opted out” of medicare as a direct specialty care physician and this means she does not accept payment from Medicare for any services. In order to accept direct payment from a Medicare patient, a separate private contract must be maintained and on file at all times between the Medicare patient and Dr. Biggee.  Medicare does not allow patients to submit a bill/superbill for reimbursement. 

At this time Dr. Biggee is not accepting Medicaid/Masshealth patients and does not bill Medicaid/MassHealth. As required by Massachusetts law, Dr. Biggee does participate with MassHealth as an “Ordering, Referring and Prescribing” (ORP) provider but she does not directly bill. For patients who are covered by any Medicaid/MassHealth plan, please refer to the state-approved provider network which lists primary care physicians accepting new Medicaid/MassHealth patients.

Patients may use their insurance for laboratory, imaging tests, physical therapy, outside referrals but please keep in mind that Dr. Biggee is an out of network provider.  Some labs or studies ordered by an out of network provider may not be covered due to individual insurance policies.  For questions regarding medical coverage, please contact insurance carriers directly.   The practice has resources to offer discounted direct pay prices to vendors of certain laboratory tests. Direct pay to a laboratory vendor may be cheaper than lab prices through insurance. This may be especially important if a patient has a high deductible insurance plan.  Patients can compare insurance vs direct discounted cash payment to the vendor and choose which is better.  For discounted x-ray and images in Massachusetts see our Resource Section

Registered new patients are encouraged to utilize the practice's secure HIPPA-compliant electronic medical records portal.  We kindly asks medical records to be uploaded by the patient onto their portal.    Further instructions will be reviewed once a patient registers. 

In some cases Dr. Biggee can be a primary Rheumatologist, however, since she is a direct care specialist and an out - of - network provider, she does not have admitting privileges to  local hospitals.  If a patient requires frequent  hospitalizations, infusion medications, or obtains frequent hospital based lab and diagnostic testing, it is  best to also establish care with a hospital based in-network Rheumatologist.  If a patient has a severe health condition or medical needs that might require extensive hospital based care, a physician who accepts a traditional health insurance model may be more suitable.

Dr. Biggee is a consulting physician only but works collaboratively and  closely with primary care providers.  The practice requires patients to have an active primary care provider for coordination of complete and safe care.