The mission of MyCatholicDoctor is to make Catholic healthcare available to everyone.  We are committed to offering you our services regardless of your insurance status or ability to pay.

Will this visit be covered by my insurance company?

MyCatholicDoctor accepts most insurances. If you do not have insurance, are out of network, or use a health sharing ministry, please see the chart below for our self-pay discounted rates. We will bill your insurance company for medical and/or mental health 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 benefits inquiries and pre-authorizations and our policy regarding copays, coinsurance and deductibles.

MyCatholicDoctor now accepts all Medi-Share patients. Your appointments will be billed in the same manner as a standard insurance plan.

Please view the list of in-network insurance plans on your provider’s profile 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 send the provider a message or see the “In-Network Carriers” section of the provider’s profile.   

After your appointment, you will receive a bill in the mail. If you have an outstanding balance, you may also receive email, phone and text reminders. If the cost of your co-pay or “patient responsibility” is more than our low self-pay rates (see below), please contact our billing department at (314)-888-5233, option 1. We will speak with you personally and work out a financial solution.

If your insurance company is “out-of-network,” you will be billed your “out-of-network” co-pay for an office visit. For insurance pre-verification, please see below.

What about health sharing ministries?

At this time Medi-Share is the only health sharing ministry we are able to bill directly. For all others, our discounted “self-pay rates” will be billed to your patient account. If needed, please contact our billing department to request detailed receipts or other documentation required by your health sharing ministry for reimbursement. You will be responsible for obtaining reimbursement from your health sharing ministry. When scheduling an appointment, please choose the self-pay option.

What if my insurance refuses to pay?

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.

What if I am uninsured and/or unable to afford your self-pay rates?

Please speak with your provider directly regarding your needs. We are committed to caring for you.

I still have questions

You can contact our billing department at (314)-888-5233, option 1.

Our Billing Address
MyCatholicDoctor
1180 Newfield Ave.
Stamford, CT 06905
(314) 888-5233

Discounted Self-Pay Rates

New self-pay patient visits are typically $175 – $250 and follow-up visits range from $75 to $250, depending on the complexity of the condition, which can only be determined by the physician during the appointment itself. The chart below can provide an estimate for you.

Please note: these rates reflect our self-pay discounts and are not eligible for reimbursement from your insurance company.

Additional time is typically $30 per 15 min.

Medical Conditions

Tier 1 - $75

  • Minor medical visits
  • Brief urgent care
  • Follow-up visits
  • Brief provider-to-provider consultations
  • Brief physical therapy follow-up visit

Typical CPT(s): 99202, 99212

Tier 2 - $125

  • Chronic care management
  • Moderate urgent care
  • Short restorative reproductive health/NaPro follow-up visits
  • Initial behavioral health visit with primary care physician
  • Low and moderate complexity COVID visit
  • Physical therapy follow-up visit

Typical CPT(s): 99203, 99213

Tier 3 - $175

  • High complexity COVID visit
  • Medium restorative reproductive health/NaPro follow-up visits
  • Initial PT (physical therapy) consultation, complex PT follow-up, PT re-evaluations
  • Well child visits / annual physicals

Typical CPT(s): 99204, 99214

Tier 4 - $250

  • Restorative reproductive health/NaPro follow-up visits
  • Initial medical evaluation of complex medical conditions
  • Second opinions on complex medical conditions
  • Ethics and end-of-life care consultation
  • Comprehensive COVID Care, usually requiring prolonged time

Typical CPT(s): 99205, 99215

Tier 5 - $250 - $370

Some specialty consultations require clinicians to perform substantial medical records review and/or follow-up tasks. These visits are billed by clinicians based on total time and complexity. Some examples include:

  • Initial Restorative Reproductive Health/NaPro technology consultation
  • Long/complex restorative reproductive health/NaPro follow-up visits
  • Functional Medicine consultations
  • Lifestyle Medicine consultations

Typical CPT(s): 99205/99215 + 99417(x4)

Behavioral Health

Tier 1 - $100

  • 30-minute established patient follow-up session with licensed counselor or social worker

Typical CPT(s): 90832

Tier 2 - $125

  • 45-minute established patient follow-up session with licensed counselor or social worker
  • 30-minute follow-up with PhD psychologist

Typical CPT(s): 99203, 99213, 90834

Tier 3 - $175

  • 60-minute established patient follow-up session with licensed counselor or social worker
  • Counseling session with an independent specialist. These providers are identified as such on their profile page and do not accept insurance or healthshares. We do provide an itemized bill that you may submit to your insurance or healthshare.

Typical CPT(s): 99204, 99214, 90837

Tier 4 - $225 - $250

  • 60-minute Initial evaluation with licensed counselor or social worker (typically first session)
  • 60-minute Initial psychiatric evaluation by MD, DO or PhD Psychologist

Typical CPT(s): 90791, 90792, 99205, 99215

NFP and Fertility Awareness

Tier 1 - $75

Not applicable

Tier 2 - $99

  • Initial and follow-up natural family planning/fertility awareness visit with a certified fertility care practitioner.
  • Chart reviews

Typical CPT(s): 99404

Tier 3 - $99 - $175

  • Fertility awareness session with an independent specialist. These providers are identified as such on their profile page and do not accept insurance or healthshares. We do provide an itemized bill that you may submit to your insurance or healthshare.

Tier 4 - $250

See Tier 4 Medical Conditions above for restorative fertility and NaPro technology services.

Tier 5 - $250 - $370

See Tier 5 Medical Conditions above for restorative fertility and NaPro technology services.

Other Specialties

Tier 1 - $59 - $75

  • Lactation consultation
  • Vaccine or pharmaceutical consultation with PharmD
  • Weight management follow-up with a nutritionist, health coach or similar
  • Follow-up with a behavioral health and wellness coach
  • Follow-up with specialized nursing care including hospice and incontinence care

Typical CPT(s): 0592T, 99402, 99403

Tier 2 - $75 - $99

  • 60-minute initial weight management consultation with a nutritionist or health coach
  • 60-minute initial consultation with a behavioral health and wellness coach
  • 60-minute initial visit with a specialized nurse for hospice
  • 60-minute initial visit with a specialized nurse for incontinence care
  • Speech and language therapy, follow-up

Typical CPT(s): 0591T, 99404

Tier 3 - $125 - $250

  • Speech and language therapy, initial visit

Tier 4 - $250+

  • Sleep Studies – $250

Benefits Inquiries

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.

Full benefit inquires are more in depth and are most useful for current and prospective patients who expect expensive or ongoing care. 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. Please note that benefits inquiries are specific to one provider. Multiple inquiries may be submitted if you intend to see multiple providers within our organization.

To receive a complimentary benefits inquiry, please complete this form:

Benefits inquiries can take up to 10 business days for a response, though we strive for as quick of a turn around as possible. A benefits inquiry cannot be performed until the above information is provided in full.

In the event that your coverage is different than what is quoted, or if you are unable to determine if one of our clinicians is in your network, please reach out to our billing department at [email protected] or call 314-888-5233 ext.2020.

Pre-Authorizations

Many plans require prior authorizations before a first visit, or cover the first visit and require a prior authorization for additional care. It is the responsibility of the patient to request an authorization prior to coverage being needed. Please allow up to 5 business days for prior authorizations to be submitted. In the event an authorization is needed, please wait until you have received confirmation the authorization request has been approved prior to seeing our providers, to avoid claims denials from your insurance company.

If your insurance company or your benefits inquiry has indicated you need a prior authorization before services can be rendered, please send an email to [email protected] to make this request. Prior authorizations are not needed on all plans, and vary based on coverage.

Our pre-authorizations have three tiers for pricing. A generic prior authorization that requires an online inquiry or basic paperwork is free. You will receive an invoice with the line item “PRI00”, and no charge. Authorizations that require chart note access and peer reviews will range from $25-$50, and will be billed directly to you as a non-covered administrative service, with codes “PRI25” and “PRI50”, respectively. Please note that coverage is not a guarantee of payment from your insurance company.

Copays, Coinsurance and Deductibles

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 My Catholic Doctor clinician 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. Unlike a brick and mortar medical office, we do not collect these fees at the time of the visit. Instead, these amounts up to $75 will automatically be charged to the authorized credit card you placed on file with us when you scheduled your appointment and a receipt will be sent to your email.

Provision of Your Good Faith Estimate

In compliance with the No Surprises Act, MyCatholicDoctor 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 fill out this brief form, and your Good Faith Estimate will be emailed to you.

No Surprises Act

In compliance with the No Surprises Act, MyCatholicDoctor, as a virtual care organization without healthcare facilities, is required to provide the following disclosure statement to uninsured individuals and to individuals who choose to self-pay.

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost

Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the healthcare provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.

If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.  Make sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email [email protected], or call 1-800-985-3059.

PRIVACY ACT STATEMENT: CMS is authorized to collect the information on this form and any supporting documentation under section 2799B-7 of the Public Health Service Act, as added by section 112 of the No Surprises Act, title I of Division BB of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260). We need the information on the form to process your request to initiate a payment dispute, verify the eligibility of your dispute for the PPDR process, and to determine whether any conflict of interest exists with the independent dispute resolution entity selected to decide your dispute. The information may also be used to: (1) support a decision on your dispute; (2) support the ongoing operation and oversight of the PPDR program; (3) evaluate selected IDR entity’s compliance with program rules. Providing the requested information is voluntary. But failing to provide it may delay or prevent processing of your dispute, or it could cause your dispute to be decided in favor of the provider or facility.

State-Specific Notices

California
Notice for patients from California: Our telehealth services for California patients are rendered by “Chuck R. Colas, DO, PC”, the title of a MyCatholicDoctor company duly incorporated in California.

Texas
We are required to provide you with the contact information for the Texas Medical Board in the event that information is needed. Their contact information can be found here.