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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 state it this way:

If Dr. Berglund decided "I'm not billing the insurance company until I get this patient entirely better." Then, once the patient is completely and by objective measures better, Dr. Berglund says "Here's what it cost to fix this patient. Please pay me."

 

The insurance company would then ask: "What did you do?"

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

The insurance would continue: "Please submit the procedure codes of the treatments you gave the patient and if we approve, we'll pay for all the care."

Berglund: "It really doesn't matter WHAT I did. What matters is that the patient is by my standards and by their standards, better.  You don't need to approve of 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 some made them worse and they had additional treatments necessary to correct the issues they 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. They only need to point to the diagnosis and validate that it was on the list of appropriate treatments for the diagnosis they gave him/her."

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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