Frequently Asked Questions

Dr. Winner and Dr. Kretzer are out-of-network gynecologists and we are not contracted with any insurance companies. However, our biller can submit your receipt (superbill) to your insurance for you, so you may get reimbursed for a portion of the bill if you have out-of-network benefits.

Most PPO insurance plans do provide some out of network coverage. Please contact your insurance provider for details about your specific plan.

We accept traditional credit cards, HSA (health savings account) or FSA (flex spending account) cards, or CareCredit (a credit card that can be used for medical expenses). We require payment for office consultations and surgeries at the time of scheduling.

Unfortunately, due to Washington State and federal laws, we are unable to see patients with Medicaid or TriCare even if you are willing to pay out-of-pocket.

If you have out-of-network benefits, your insurance company may reimburse you for a portion of the consultation and/or surgeon fees. As a courtesy to our patients, we have employed a biller who can submit a courtesy claim to your insurance for you. Alternatively, our biller can send you the itemized receipt and you can submit it to your insurance. Be aware that both of these processes can take a long time - several months or longer. 

Unfortunately, sometimes the insurance company will mistakenly reimburse the clinic. In these situations, we void the check, and you must appeal to your insurance company to have them send a check to you instead. Under no circumstances do we cash the check and then reimburse you, as our clinic is specially set up to never accept payment from insurance companies (doing so would put us in the middle and create an administrative burden that would make it impossible to keep our doors open). This system is allowed because all of our patients sign the No Surprises Act waiver prior to being seen. 

Many customer service agents at insurance companies are not well educated on these matters, so you may need to ask to talk to an upper-level manager, and/or file a formal appeal. Your insurance company will provide you with the forms necessary to file the appeal, and when submitting, include a copy of the No Suprises Act Waiver and the Good Faith Estimate documents that you signed. Filing the appeal is your responsibility, our biller cannot do this for you. The only courtesy services we offer are submitting a courtesy claim to your insurance for you and/or sending you an itemized receipt for you to submit to your insurance company. We do not have the bandwidth to assist with appeals or any other back-and-forth with your insurance company after that. It is important to understand that  appeals are not always successful, and some insurance companies refuse to reimburse patients. 

We partner with CareCredit to offer payment plans if necessary.

We do not offer refunds, however, if you need to reschedule and do so with more than 24 hours’ notice in advance of your appointment, there will be no fee to reschedule and any fee paid for the appointment or procedure will apply to the rescheduled appointment. If you reschedule with less than 24 hours’ notice from your appointment, there will be a $50 rescheduling fee and any fee paid for the appointment or procedure will apply to the rescheduled appointment.  If you cancel your appointment and do not reschedule or miss your appointment, there is no refund of fees paid.

If you need to reschedule your surgery and do so with 10 or more business days’ notice in advance of your scheduled surgery date, there will be no fee to reschedule and any fee previously paid for the surgery will apply to the rescheduled surgery. If you reschedule with less than 10 business days’ notice from your scheduled surgery date, there will be a 10% rescheduling fee from the fee previously paid for the surgery and any fee previously paid for the surgery will apply to the rescheduled surgery.

If you cancel your surgery with 10 or more business days' notice in advance of your scheduled surgery date, there will be a 25% cancellation fee from the fee previously paid for the surgery. You will be reimbursed the remainder of the fee previously paid for the surgery. If you cancel your surgery with less than 10 business days' notice in advance of your scheduled surgery date or if you miss your surgery, there will be a 50% cancellation fee from the fee previously paid for the surgery. You will be reimbursed the remainder of the fee previously paid for the surgery.

Yes. Contact your insurance company for specific details about your plan.

Yes. We partner with CareCredit to offer interest-free payment plans up to 6 months.

We frequently hear from patients that they are frustrated with long wait times, short appointments, and physicians who do not have specific training or surgical skills to treat complex gynecologic conditions. 

These issues stem, in part, from poor reimbursement from insurance companies for women's health, requiring OB/GYNs to see a large number of patients per day. Other factors include an emphasis on obstetrics (taking care of pregnant women and delivering babies) in OB/GYN residency training, and higher reimbursement for obstetrics than gynecology. 

This is all a reflection of how insurance companies and society as a whole values women and women's health (thanks patriarchy). This is why minimally invasive gynecologic surgeons, urogynecologists and menopause specialists are all in short supply with high demand.

In addition, physicians who are in-network have to employ a large number of staff to do battle with the insurance companies to get patients the care that they need (hours on hold on the phone to obtain preauthorizations, fighting denials, doctors spending their lunch breaks doing peer-to-peer calls explaining why a treatment is necessary even though it is already in the note, following up on unpaid bills, etc).  

Small independent gynecology practices suffer even more, as they do not have negotiating power with insurance companies to get fair contracts.  In fact, some insurances will not even partner with solo practitioners. This is why many private practices (even those that practice obstetrics) are going out of business (Google "Seattle OB/GYN" to hear one sad story of what should have been a very successful practice going out of business).

These issues are especially true for complex gynecologic surgery, which reimburses significantly lower than other surgical fields such as orthopedic surgery or urology. Again, this is all a reflection of how women's health is viewed and valued by insurance companies. 

In addition, endometriosis surgery procedure codes are outdated, so that a quick ablation of one spot of endometriosis reimburses the same as an extensive excision of endometriosis from multiple and/or tricky locations. For this reason, and all the reasons listed above, almost all private practice endometriosis excision surgeons are out of network.

To make a long story short: We would not be able to provide the personalized, subspecialized, high-quality, detail-oriented, and multi disciplinary care that we know patients need and deserve if we were contracted with insurance companies.  We are sorry.  We wish it was different.

• Access to highly sought-after, expert minimally invasive gynecologic surgeons

• No long waits for consultations or surgery

• Fewer delays due to prior authorizations or insurance denials

• Messaging and postoperative checks with your surgeon, not a physician's assistant

• Ongoing support from an integrated multidisciplinary care team including pelvic floor physical therapy, acupuncture, nutrition and mental health counseling

• Simple, transparent pricing and help with submitting your superbill to insurance

• Physician-owned, woman-owned practice