How We work

We put patients first. We answer your calls and emails directly. Direct access to primary care helps my patients stay healthier and have their medical issues resolved quickly.

The Balance Medical Clinic ethos:
  • Establish a personal relationship with each patient, one-on-one.
  • Offer no-hassle, time-saving phone and email consultations, over 50% of all care issues are resolved without an office visit.
  • Set prices that are affordable and our fees are transparent.
The Balance Medical Clinic New Patient Process:
  1. To get started fill out the form on this page and Dr. LaShay will contact you for an initial phone call to determine if she is the right doctor for you.
  2. Then we need to set up an initial check-up so that we can get to know your medical status in detail. We will send you an online HIPPA compliant secure medical form to fill out and then you will have a 30 minute phone call with Dr. LaShay.
  3. After that we will schedule an introductory office visit which generally lasts about 30 minutes.
  4. Once we’ve met you in person to establish a patient-doctor relationship, you’re ready to take full advantage of care that is customized your for needs.

Pricing and plans

No “membership” fees – Only pay for the time you use!
  • At Balance Medical pricing is affordable and transparent. We use time-based billing, just like many other professional services.
  • We are an out-of-network provider for most insurance plans. Statements for your visits with us can be submitted to your insurance company for reimbursement.
  • We are not a traditional concierge practice and therefore do not charge a large up front fee to be a member of our practice. You only pay for the time you use.
  • Our fees are time-based and we bill in increments of 5 minutes of time.

How we work with Insurance

Insurance Types
  • Payment of medical services provided by Balance Medical Clinic will depend upon the type of health insurance you have. An overview of coverage under the different types of plans is provided below:
    • Balance Medical Clinic works especially well for people with preferred provider organization (PPO), point of service (POS), or private insurance plans (fee for service), where patients can choose who they want to see. With these plans Balance Medical Clinic can order all tests, labs, x-rays, referrals and medications. In many cases this can be done without an office visit and your charge is not much more than a co-pay. If an office visit is needed, the proper documentation can be provided to patients for submission to their insurance company.
    • Balance Medical Clinic is clearly a superior practice for patients who will pay most of their medical costs out of pocket. This includes those with a high deductible medical insurance plan, a medical or health savings account (HSA), or simply no insurance coverage. Assuming the average person needs about an hour of care per year, I estimate that this care will cost about $300.00 under the Balance Medical Clinic system compared to a traditional office charge of $400.00.
    • Health maintenance organizations (HMOs) do not reimburse for phone or office visits with doctors outside the plan. However, prescriptions are covered for patients regardless of which doctor calls in the medicine. In some plans, laboratory tests and x-rays may be ordered by any primary care physician, as long as the patient goes to a laboratory that participates in the plan. You need to check with your insurance representative about this. Even where costs are not fully covered by the insurance plan, HMO patients will still benefit from the convenience of getting help and medications through Balance Medical Clinic. If an office visit is not necessary, the cost will not be much more than your HMO co-pay. Balance Medical Clinic also may provide medical services not covered under your HMO insurance plan.
    • Medicare works somewhat like an HMO. Medicine prescriptions provided by Balance Medical Clinic will be covered, as will some limited laboratory tests and x-rays. For those patients who have primary insurance apart from Medicare, the office visit bills will be paid by the primary insurance when a claim is submitted. For Medicare patients without other primary insurance, physician fees and office visits may need to be paid out of pocket. The services of Medicare-assigned doctors will therefore be less expensive. But Balance Medical Clinic can provide many medical services not covered by Medicare (such as routine physical exams), and when it comes to convenience, access, and saving time, Balance Medical Clinic remains an excellent choice.
Submitting a Claim
  • Insurance frequently forces you to jump through hoops for reimbursement. As part of my service to my comprehensive service to our patients. We have put together a tutorial that may save you a major headache during this process.
    • Applying for reimbursement is straight-forward. You must submit two forms to the insurance company:
      1. Acquire the insurance Invoice from Balance Medical Clinic. This form says “Paid in full” in red letters and has Diagnostic ICD-9 codes and CPT billing codes. After paying for service, you may either collect this Insurance Invoice in person or Balance Medical Clinic will email it to you.
      2. An insurance claim form that can be downloaded from your insurance company’s web site. For your convenience, I’ve posted links to the forms and a majority of the insurance companies on my Insurance Forms page. If you are unable to find a claim form for some reason, a more complicated but universally accepted claim form, ” HICFA 1500,” can be downloaded and submitted instead. It takes several minutes to fill out the claim form.
      3. Mail the Insurance Invoice and completed claim form to the designated address on the claim form or on your insurance card.
Word of Caution
  • Keeping your information confidential might be important to you. Remember that every time you use your insurance company for payment, they systematically collect the diagnostic codes and any medicine you are obtaining (assuming the insurance company is helping pay for them). Although this is a rare event, they also have the right to withhold payment until they audit your medical note. At Balance Medical Clinic, we never release medical notes to insurance companies without your verbal, and in some cases, written consent. Our policy is that you paid us for the care and therefore the information regarding the service or visit belongs to you.
  • Insurance companies create a health information database like a “credit report” on any services they are helping you pay for. This information can be used in the future to stratify your risks should you ever be looking to apply for health insurance in the future. Claims adjusters have access to this file when they are trying to decide if you merit getting insurance.
  • Mail the Insurance Invoice and completed claim form to the designated address on the claim form or on your insurance card.
  • Medicare
    • Medicare works somewhat like an HMO. Medicine prescriptions provided by Balance Medical Clinic will be covered, as will some limited laboratory tests and x-rays. For those patients who have primary insurance apart from Medicare, the office visit bills will be paid by these companies when you submit a claim. For most other Medicare patients, physician fees and office visits will need to be paid out of pocket. The services of Medicare-assigned doctors will therefore be less expensive.

New Patient Initial Contact

Please call us directly at 855-502-2526

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Contact

Nanette LaShay
825 Oak Grove Ave, Suite D101

Menlo Park, CA, 94025 United States of America