Studies show that physicians are now spending a significant amount of time and resources billing and fighting insurance companies. It is YOUR responsibility to know your plan benefits.
While we verify that your insurance is active and do our best to determine all your benefits, it is ultimately YOUR responsibility to know your coverage and render payment for the services you receive. Your personal health insurance policy is an agreement that you have made with your insurance company. In order to better understand your benefits and whether or not you have in-network and/or out-of-network chiropractic benefits, please contact your insurance representative. Please let us know if you have been involved in a motor vehicle accident and plan to file with your car insurance. We do not accept third-party claims.
If you have health insurance, and your benefits include Chiropractic Care, you may hear terms like "medically necessary", "active care" or "maintenance care". So, let's start by defining these terms:
Medically Necessary - According to Medicare.gov, “medically necessary” is defined as “health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms, and that meet accepted standards of medicine.” For any of those circumstances, if your condition produces debilitating symptoms or side effects, then it is also considered medically necessary to treat those.
Active Care - This is care/treatment for a health condition or symptoms aimed at providing significant, lasting, or progressive improvement to your condition. Your provider is providing care to either eliminate and resolve your condition, or to stabilize it.
Maintenance/Wellness Care - Once you have reached the point where your condition is "resolved or stable" or you have reached "max medical improvement" (you may still have some pain or symptoms, but the condition has stabilized and not expected to further improve/change), your health insurance plan will no longer cover additional treatments. They consider the "active/medically necessary" phase of care completed. In general, insurance companies are not focused on any preventative or wellness services. They were designed for quick, short-term symptom and disease care and treatment, this based on the conventional model of health care which typically relies on drugs and surgery. However, if you suffer a new injury or complaint, or have a flare-up of your existing condition, you move back into "active care," which IS covered under your insurance again.
Maintenance/Wellness Care is an important part of keeping you healthy and preventing further problems. You can continue to receive this important care on a out-of-pocket basis. Our office makes this affordable by offering rates that are in line with what most co-pays are.
As a friendly reminder, payment is expected at the time of service. We do accept HSA/FSA cards. We also accept Cash, Debit/Credit Cards, or Check. We are currently in-network with BlueCross BlueShield, all others are considered "out-of-network, and your benefits may vary. (**If your BCBS policy is through Walmart, they will not cover Chiropractic care, so be sure to take their survey each year and request that they add that to your plan!!). If you have out-of-network benefits, we can provide you with a superbill if you would like to be reimbursed. If finances are a barrier, please speak with us about a financial hardship plan and various options.
If you are on any medications or have any recent diagnostic reports or images (ex. X-Ray), please be sure to bring a list of those medications for our records.
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