Your Questions, Answered
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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 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.
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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.
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First, schedule a discovery call for an educational session about the practice. No direct medical advice is given and this call does not constitute a physician patient relationship. Second, a one-time initial new patient consultation may be scheduled. This includes a 60 minute face to face consultation with Dr. Biggee, a comprehensive Lifestyle and Integrative Rheumatology assessment and initial plan, and a 30 minute follow up with option to join a membership plan. Third, sign up for a 12 month membership for ongoing comprehensive and supportive care.
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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
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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.
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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.
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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. Medicare will still cover lab tests, imaging, and medications ordered by Dr. Biggee. cription
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At this time Dr. Biggee is not accepting new Medicaid patients. She does not bill Medicaid directly and direct physician-patient contracts for medical services are typically not permitted by Masshealth. For patients contracting with any Medicaid plan, including those on the mass health connector, please refer to the state-approved provider network for physicians accepting new Medicaid patients.tem description
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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.
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All new patients must register on the practice's secure HIPPA-compliant electronic medical records portal. The practice is a paperless office and kindly asks medical records be uploaded onto the patient’s portal. Please do not fax or mail paper records. Further instructions will be reviewed once a patient registers.
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In most 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.
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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.