The NUNM Health Centers uses a non-fixed-fee system for most clinic services to remain in compliance with state and federal laws and to honor contracts with insurance companies. For patients with insurance that covers our services, we will bill the insurance company.
Patients with any form of insurance that doesn’t cover our services and/or patients who are without insurance coverage are expected to cover the cost of the office visit themselves.
Coding & The Cost Of Care
In this fee structure, the cost of the visit depends on how it was coded (which Current Procedural Terminology (CPT) codes are used) by the providers. The codes used will be based on the length and complexity of the care a patient received.
Patients will have an Evaluation and Management (E&M) code plus any acupuncture or ancillary technique or procedure codes. Acupuncture is billed in 15 minute increments, so the length of time spent in active face-to-face time with the patient will determine which codes are used/billed.
We welcome patients to review a copy of the NUNM Health Centers Fee Structure Guide.
Good Faith Estimates
According to new legislation, health care facilities are required to provide individuals with a good faith estimate (GFE) of the cost of an appointment booked more than 3 days in advance when services are not covered by the insurance company or a patient elects to pay for services themselves.
This summary is meant to provide a patient with an estimate of the cost of care. Please note that estimate is not a guarantee of pricing, but rather a guide to help patients prepare for the financial impact of receiving services. These estimates will arrive to patients by MyChart message when an account is active or through physical mail. Our scheduling team can help give you a range of the cost for services when you call to set up an appointment.
You can review your Right to Receive a Good Faith Estimate of Expected Charges in this posted notice.
Compassionate Care Program
Discounts are only available to patients who pay in full at the time of their service.
All uninsured or underinsured individuals can apply for our Compassionate Care Program (CCP) and obtain discounts on the cost of their office visits if found to be eligible. Discounts are between 60%-75%, and are determined by a patient’s confirmed income as a percentage of the federal poverty level (FPL). Any patient could receive a 40% discount for full payment at time of service (TOS), without enrolling in the CCP.
Participation in the Compassionate Care Program is not required of patients, but an active application is required for a tiered discount.
Those found eligible for the CCP and have provided income documentation as verification will maintain their Tier status for a full year. Each year the Federal Government will update the guidelines around the poverty level, which may impact the level of discount that is available to the individual. The CCP is reviewed on an annual basis. NUNM reserves the right to modify this discount program as necessary with advance notice.
Honored Citizens & Time Of Service Discounts
NUNM wishes to honor community members who have meet the following criteria with an automatic 65% discount on office visits.
- Medicare Recipients (Federal Only)
- Veterans
- Federal Retirees
- Persons Age 62 or older
Honored Citizens may be eligible for a bigger discount if their income meets the federal poverty level requirements in our Compassionate Care Program and will be given the best discount that is applicable to them.
Time Of Service 40% off discounts are only available to self-pay individuals who can cover the cost of the office visit in full at the time of their visit. If a patient elects to have a bill sent to them then the discount will not be applied and the individual will be asked to cover the full cost of the care.
What are the discounts?
Below is the schedule of discounts and the 2022 federal poverty level guidelines.
| Family Size | 100% | 150% | 250% | 400% |
|---|---|---|---|---|
| 1 | $13,590 | $20,385 | $33,975 | $54,360 |
| 2 | $18,310 | $27,465 | $45,775 | $73,240 |
| 3 | $23,030 | $34,545 | $57,575 | $92,120 |
| 4 | $27,750 | $41,625 | $69,375 | $111,00 |
| 5 | $32,470 | $48,705 | $81,175 | $129,880 |
| 6 | $37,190 | $55,785 | $92,975 | $148,760 |
| 7 | $41,910 | $62,865 | $104,775 | $167,640 |
| 8 | $46,630 | $69,945 | $116,575 | $186,520 |
| CCP Tier | FPL % | Discount | Additional Benefit |
|---|---|---|---|
| Tier One | 0 – 149% | 75% off | 15% off Medicinary / Discounts on certain labs |
| Tier Two | 150 – 250% | 65% off | 15% off Medicinary / Discounts on certain labs |
| Tier Three | 251 – 400% | 60% off | No discount on Medicinary items or labs |
| TOS Discount | >400% | 40% off | No discount on Medicinary items or labs |
| Honored Citizens | Medicare Recipients (Federal Only) Veterans Federal Retirees Persons Age 62 or older | 65% off | No discount on Medicinary items or labs |
*Any prices and discounts are subject to change. Pricing and discount options are reviewed and updated annually.*