Helpful Insurance Information:
We are participating providers (in-network) with most large insurance networks. For patients who belong to a network, with which we are not affiliated, discounts are often available. Please ask if we are participating providers when you make your first appointment.
Insurance benefits vary from one company to another. They often varies within one insurance company. Each insurance company offers a variety of plans. It is important to be aware of your individual situation. Generally, PPO plans include Chiropractic coverage (Skeletal manipulations) in the out-patient therapy section. It is often listed with Occupational and Physical Therapy. These types of care are generally subject to your plan deductible and coinsurance.
Allowable charge: Once a patient’s deductible is met, often Chiropractic care is covered at 80% of the allowed charge. The allowed charge varies from company to company. We keep a list of the allowable charge for all insurance companies, with which we participate. The 20% remaining is referred to as coinsurance and is the patient’s responsibility.
Deductible: (usually an annual amount) the amount for which the payment responsibility is the insured's each calendar year before an insurance company will make payment.
Co-insurance: the patient’s portion after the deductible is met
Care limits: There are often limits to the number of visits covered under your plan. In other cases, there is a dollar amount limit to Chiropractic Coverage.
Pre-approval: There are sometimes pre-approval procedures that have to be followed to obtain coverage. We are happy to help you maneuver the ins and outs of your individual insurance coverage.
Co pay: a small fixed amount required by a health insurer to be paid by the insured for each outpatient visit
Most HMO, plans have a co pay (patient’s responsibility) for each visit. This amount is often indicated on your insurance card as the specialist co pay. Often we are considered specialists by your insurance company. For best information, call or check your insurance company website or booklet. Always look for Chiropractic as its own category or look for it under outpatient therapy. Be advised, some HMO plans, Aetna for example, require a referral by your primary care physician. It should be noted on your insurance card if a referral is necessary. All patient portions, (deductibles, coinsurance, co pays) are expected at the time of service unless other arrangements are made in advance of the appointment.