Pricing and payment

Pricing and Payment
We respectfully ask for payment at the time of service. We accept all major credit cards, cash, HSA, and FSA accounts. We also accept care credit.
 
New Patient Office Visits 
- $400 (60-minute visit)     - $475 (90-min or longer visit)
 
We ask for a $100 non-refundable prepaid deposit for all new patient appointments.  This one-time fee will be applied to your visit. 
 
Before your initial visit, an initial phone history will be reviewed with you. We will make sure that even before you come in for your first visit, we have all of your previous records and imaging to review. 
 
The first visit to our office will be unlike any visit you’ve had with a doctor before. Your entire medical history and shared documents will be reviewed with you in person, and an in-depth physical exam will be performed. Our goal is wellness and prevention, so we will spend the time needed to get to the root cause of your issue.  
 
Follow up visits range in cost based on the length of the visit and the type of visit (primary care visits that are 30 min are a different cost than a 90 min functional medicine follow up visit.)
During your initial visit, after your evaluation, you and Dr. Kelner will discuss your treatment plan in detail.  

Insurance Claims 

FORM Medical will work with all insurances as an out of network provider.  Many insurance plans have out of network benefits that may cover some of the services you receive here at FORM Medical. We will provide you with an itemized statement that you can submit to your insurance company for possible reimbursement along with a HICF (Health Insurance Claim Form).  The forms will be marked asking the insurance company to send any reimbursement directly to you, the patient.
Please note: Health insurance is a contract between you and your insurance carrier only. We are not part of your contract and can in no way guarantee any level of insurance reimbursement. While we withdraw from involvement in insurance disputes, we will provide you and/or your insurance company, with any information that we are able to release. We strive to provide you with the finest level of care and will continue to help you attempt to get the most reimbursement you can from your insurance company.
Your insurance company will send you a check in the mail for what is covered by your plan. The reason we are not an in-network provider is because it limits the quality of care by dictating a patient’s visit time and the type of care we can provide. We are able to provide the highest quality of care by being out of network, truly allowing us to serve our patients.
 
We are Out of Network
Our goal at FORM Medical is to get to the root cause of your issue or medical illness and help you to heal, while preventing new issues from coming up.  Doctor’s offices that accept in network insurance are often rushed to see a patient in 15 minutes or less.  At FORM Medical, we believe in investing the needed time with patients to provide the highest quality care.  

HSA/FSA Funds 

Funds from Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) can be used for our services. Many patients with these accounts find that this is an excellent way to use their non-taxable health care funds for medical care outside of their network plans! 

Have specific questions about costs? Call us at 720-370-9559. 

We can do our best to outline approximate costs prior to scheduling your first appointment. Keep in mind, we do not know in advance which treatment, if any that you will need.  

All prices are explained upfront. Neither lab tests or treatments will be performed without the patient’s approval.  If finances are an issue, we can work with you to help you get the treatments needed.