Reclaiming Our Bodies - Insurance & Billing

Insurance & Billing

Simon is only in-network with Regence and Premera insurance at this time.
We offer a self-pay option for people who are uninsured or have out-of-network insurance. See below for more details.
We are still getting set up. In the coming months we hope to be in-network with more of the major private carriers in the region.
At this time we are not able to accept Apple Health, Medicaid, or Medicare. We hope to be able to expand access in the coming years.
For questions about billing, please reach out to our billing team. Contact information here.

Additional important information on billing can be found below.

Insurance & Billing: More Details

You have a right to billing transparency! To read more about Washington's "surprise billing" protections, click here.
Reclaiming Our Bodies' practice style and values center listening, autonomy, and offering a range of recommendations and options around ways to move forward. This kind of work takes time, and visits are typically 30-55 minutes, sometimes longer.
Medical billing is complex and fundamentally unjust both towards patients and providers. Within the constraint of insurance contracts, legal requirements, and the realities of late stage capitalism, Reclaiming Our Bodies strives to bill as ethically as possible.
Reclaiming Our Bodies primarily uses a time-based system to create billing codes that are attached to each visit. Time based billing includes time spent face-to-face on the day of the visit, time preparing for the visit, and time documenting and coordinating care after the visit.
Other things that might affect a bill are the level of medical complexity addressed, any procedures done, medications administered, and vaccines given, among other things.
Every insurance plan is different in what they cover, and how much they cover. Yours might have unique exclusions, requirements, or policies that affect your total bill responsibility. Exactly which billing codes are used is determined after the visit, and can't be guaranteed ahead of time. See below for some common codes billed by Reclaiming Our Bodies.
My focus will always be on your healthcare first, and I won't always know what costs will look like for you. I am happy to offer what insight I can, but ultimately you'll want to check with your insurance company and advocate for the answers you need.
Payments are accepted via credit and debit card only, and patients must maintain an active card on file for copayments, outstanding balances, and any other applicable fees.
If you are having trouble paying your remaining balance after the visit, please reach out to the billing office and we may be able to set up a payment plan.

A Note About Annual Physicals

Many insurance plans cover annual physicals 100%. Sometimes these are called 'annual wellness' visits or 'preventative health' visits. Unfortunately they only allow us to address preventative health issues in the visit - things like vaccines, cancer screenings, and screening for heart health issues.
Typically during annual physical other things come up - like high blood pressure, sleep issues, PrEP prescriptions, depression, etc. They do not generally allow us to address or document those concerns on the annual physicals, order labs for them, or write prescriptions for them, etc.
However! We can still usually address them on the same day, we just have to create a separate note that gets billed using one of the "health concern" codes listed below.
So for the day of your annual physical you might see a bill for both the preventative health portion of the visit and a separate one for the concerns addressed that day.

Common Billing Codes

Some codes commonly used and the associated billing amounts are listed below. These codes and time guidelines are created by the insurance agencies, who make them needlessly complex.
Don't forget: Time based billing includes time spent face-to-face on the day of the visit, time preparing for the visit, and time documenting and coordinating care after the visit.
"New Patients" includes people who may have seen Simon at other practices but who are having their first visit at Reclaiming Our Bodies. It also includes people who have not been seen at Reclaiming Our Bodies in the last three years.
Codes for visits to address health concerns with new patients:
- 99202: 15-29 minutes
- 99203: 30-44 minutes
- 99204: 45-59 minutes (this is the code most commonly used for new patient visits)
- 99205: 60-74 minutes
- 99205 + 99417: 75-89 minutes
- 99205 + 99417 (x2): 90-104 minutes
- Additional 99417 code for each 15 minutes beyond 104 minute
Codes for visits to address health concerns with established patients:
- 99213: 20-29 minutes
- 99214: 30-39 minutes
- 99215: 40-54 minutes
- 99215 + 99417: 55-69 minutes
- 99215 + 99417 (x2): 70-84 minutes
- 99215 + 99417 (x3): 85-104 minutes
- Additional 99417 code for each 15 minutes beyond 104 minutes
Codes for annual physicals with established patients:
- 99395: for people age 18-39 years
- 99396: for people age 40-64 years
There are many other codes and types of bills that may come up from time to time. These include codes for procedures, vaccines, etc. But the ones above are the most commonly used at Reclaiming Our Bodies.

Self-Pay and Out-of-Network Insurance

If you are opting for self-pay, are uninsured, or are using out-of-network insurance, the estimated full fee for each visit will be charged to your card at the start of your visit.
If you do have out-of-network insurance please feel free to let us know. As a courtesy our billing team is happy to help you submit a claim to your insurance after the visit. Occasionally, if you have out-of-network coverage you might be able to get a reimbursement or refund from your insurance company to cover part of the cost of the visit. Of course, we can never guarantee coverage.
We recognize that paying full fee out of pocket without support from insurance can be challenging. In consideration of this, the fees outlined below reflect a 25% discount from our typical billing rates.
We value transparency. Here is some more information about estimated charges to expect, though these rates may change from time to time. Please note that we can estimate the total, but see the "More Details" and "Annual Physicals" sections for things that might affect the total bill.
- New Patient Rates as of March 2025
  - First visit to establish care: $279
- Established Patient Rates as of March 2025
  - Health concern visit up to 29 minutes: $153
  - Health concern visit 30-39 minutes: $215
  - Health concern visit 40-54 minutes: $302
  - Health concern visit 55-69 minutes: $355
  - Annual physical (ages 18-39): $219 (See above for a note about annual physical billing)
  - Annual physical (ages 40-64): $254 (See above for a note about annual physical billing)

Reclaiming Our Bodies, PLLC

Simon M. Taylor, MSN, ARNP, FNP-C, AAHIVS, LGBTQ-C

911 E Pike St #319; Seattle, WA 98122

Phone: (206) 880-3266

Fax: (206) 627-1685