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Game Over Screen

Insurance Coverage?

Why Doesn't Dr. Berglund Take Insurance?

A few decades ago, Dr. Berglund did take insurance. However, as he started treating a vast array of conditions traditionally only treated by medical doctors/hospitals, he noticed that insurance companies were not thrilled with the idea of someone coming in and treating thyroid problems or depression or anxiety or skin conditions without prescriptions or surgery. 

Let's look at it a different way. Imagine this conversation between Dr. Berglund and an insurance company:

Dr. Berglund: "I'm not going to bill you until I get this patient better."

 

Insurance company: "OK"

(Dr. Berglund evaluates the patient and puts him/her on a treatment plan. He monitors the success of that plan and adjusts dosages, lifestyle changes as needed until the patient achieves the goals that the doctor and patient set forth during the initial visit. Patient says they feel great and haven't had this level of health in a very long time.)

Dr. Berglund"The patient has improved dramatically. I am sending you my fees that I have charged to help this patient. Please pay me in full."

 

Insurance company: "What did you do?"

Dr. Berglund: "It doesn't matter. I did "stuff" and he/she is better. Please pay me."

Insurance company: "Please submit the procedure codes of the treatments you gave the patient and if we approve, we'll pay for the treatments we deem were appropriate."

Dr. Berglund: "It really doesn't matter WHAT I did. What matters is: the patient is, by my standards and by their standards, better.  You don't need to approve of or "deem appropriate" what I did.  The patient results are all that matters. Heck, you paid for all the patient's care before I saw them and, according to them, they said that those treatments didn't work. In fact, they said that some made them worse and which forced them to undergo additional treatments "deemed necessary" to correct the issues their "treatments" created. And you paid for all their visits, medications, and rehabilitation with little to no fight." 

Insurance: "We paid because they followed medical standards of care. Positive outcomes are not essential for us to pay a doctor/hospital. Providers and institutions only need to point to the diagnosis to validate that it was on the list of appropriate treatments for the diagnosis they gave him/her."

Dr. Berglund: "This is one messed up system that pays people to do the right thing that got a negative outcome and denies coverage to someone who does a "wrong" treatment protocol but got fantastic results.  I'm not playing this warped game."

This is why Dr. Berglund doesn't participate in any private health insurance plans.

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