Insurance & Financial Information | Leda Medical

Coverage Options

Types of Insurance We Work With

Leda Medical is an out-of-network practice. We work with a wide range of insurance plans and provide the documentation you need to seek reimbursement from your insurer.

PPO Plans

Patients with Preferred Provider Organization (PPO) plans typically have out-of-network benefits that can be applied toward consultations and services at Leda Medical. We strongly recommend verifying your out-of-network deductible and reimbursement rate before your visit.

Out-of-Network (OON) Plans

As an out-of-network provider, we accept most major insurance carriers that offer out-of-network benefits. Upon request, we provide a detailed superbill after each visit that you can submit directly to your insurance company for reimbursement.

Medicare

We accept Medicare for certain services. Coverage varies depending on the treatment plan. Please contact our office directly to discuss what services may be eligible under your specific Medicare plan before scheduling.

Self-Pay / Private Pay

Patients who do not have insurance or prefer not to use their insurance may pay privately. We offer transparent pricing and are happy to discuss payment arrangements to ensure care is accessible to those who need it.

HSA / FSA Accounts

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) are accepted for eligible medical expenses. Our services generally qualify under these accounts — we recommend checking with your plan administrator to confirm eligibility.

Superbill Documentation

For all visits, Leda Medical provides a comprehensive superbill with all required diagnostic and procedure codes. This document is specifically designed to streamline your out-of-network insurance reimbursement claim submission.

Treatment-Specific Billing

Important Coverage Information by Treatment

Some of the advanced therapies offered at Leda Medical have unique billing structures. Please review the information below carefully before beginning a treatment plan.

Insurance-Based

IVIG Therapy (Intravenous Immunoglobulin)

IVIG therapy at Leda Medical is billed based on your out-of-network insurance benefits. Coverage and reimbursement rates vary depending on your individual plan.

Billed to your insurance as an out-of-network service using standard medical billing codes
A prior authorization may be required by your insurance carrier before treatment begins
Our billing team will work with you to help facilitate the authorization process and provide supporting clinical documentation
Patient responsibility (co-insurance, deductibles) will vary based on your plan's out-of-network benefits
We recommend calling your insurance prior to your first infusion to confirm your OON benefits for IVIG

Please have your insurance card and member ID ready when contacting our office. Our team is happy to help you navigate the prior authorization and billing process.

Out-of-Pocket

SOT Therapy (Supportive Oligonucleotide Technique)

SOT therapy is considered an experimental or investigational treatment by most insurance carriers and is therefore not covered by insurance at this time.

All costs associated with SOT therapy are the full out-of-pocket responsibility of the patient
Insurance reimbursement for SOT is generally not available regardless of plan type
Pricing is discussed in detail during your consultation with Dr. Frid prior to initiating treatment
HSA or FSA funds may be applicable — please verify with your plan administrator
Payment is due at the time of service or as arranged with our billing team

SOT therapy represents a cutting-edge approach to complex chronic infections. While insurance does not currently cover this treatment, Dr. Frid will ensure you have a complete understanding of the costs and expected outcomes before proceeding.

The Process

How to Use Your Insurance at Leda Medical

Follow these steps to make the most of your out-of-network benefits.

Verify Your Benefits

Call the member services number on the back of your insurance card and ask specifically about your out-of-network deductible, co-insurance percentage, and reimbursement process for specialist visits.

Schedule Your Visit

Contact our office to schedule a consultation with Dr. Frid. Let us know your insurance information upfront so we can assist with any documentation or prior authorization needs.

Receive Your Superbill

After each appointment, we provide a detailed superbill with all required diagnosis and procedure codes. This is your primary document for filing an out-of-network claim with your insurer.

Submit Your Claim

Submit your superbill to your insurance company using their standard out-of-network claims process. Reimbursement timelines vary by carrier. Our team is available to answer any questions that arise during this process.

Common Questions

Insurance FAQs

Is Leda Medical in-network with any insurance plans? +

Leda Medical is currently an out-of-network practice. However, most PPO and many other plans include out-of-network benefits that can offset the cost of your care. We provide all necessary documentation to help you maximize your reimbursement.

What is a superbill and how do I use it? +

A superbill is an itemized receipt containing all the information your insurance company needs to process a claim — including diagnosis codes (ICD-10), procedure codes (CPT), provider NPI number, and service dates. You submit it directly to your insurance company to request reimbursement for out-of-network care.

Does insurance cover IVIG infusions at Leda Medical? +

IVIG therapy is billed through your out-of-network insurance benefits. Coverage varies by plan and a prior authorization is often required before treatment begins. Our team will assist you with the authorization process and provide clinical supporting documentation. We recommend contacting your insurer before your first infusion to confirm your specific coverage.

Why is SOT therapy not covered by insurance? +

SOT (Supportive Oligonucleotide Technique) is a novel, targeted therapy that most insurance carriers currently classify as experimental or investigational. As such, it is not reimbursable through standard insurance plans. All costs for SOT therapy are the patient's out-of-pocket responsibility and are discussed in full during your consultation with Dr. Frid.

Can I use my HSA or FSA for services at Leda Medical? +

In most cases, yes. Eligible medical expenses at Leda Medical can typically be paid with HSA or FSA funds. We recommend checking with your plan administrator to confirm which specific services qualify under your account.

How do I know what my out-of-network benefits are? +

Call the member services number on the back of your insurance card and ask: (1) Do I have out-of-network benefits? (2) What is my out-of-network deductible and how much have I met? (3) What percentage of the allowed amount does my plan reimburse for out-of-network specialist visits? Our staff is happy to guide you through this process.

What payment methods are accepted? +

We accept major credit cards, debit cards, HSA/FSA cards, and checks. Payment is due at the time of service unless other arrangements have been made in advance with our billing team. Please contact us if you have questions about payment options.

Understanding Your Coverage at Leda Medical