Patient Insurance Liability
The contract of medical health insurance is between the patient and the insurance company. We cannot accept responsibility for determining benefits in advance of your treatment. Possession of a medical insurance member ID card is NOT a guarantee of coverage. As a courtesy we call your insurance to get a “quote” of benefits, but it is the responsibility of the insured to verify eligibility for their own health care benefits. A quote is NOT a guarantee of payment from your insurance company. Payment is subject to the terms and conditions of your policy. It is not our claim; the insurance company is not required to pay the provider. The insurance company’s sole legal obligation is to pay the “benefit” to their member. Among other reasons, misquotes can be given, maximums can be met prior to being seen at our facility, policies and coverage can change, certain services involved in your treatment plan may not be covered under your policy, amounts billed may be above your insurance allowable.
Co-Pays and Deductibles
All co-pays, co-insurance and deductibles must be collected at the time of service. We are happy to provide the service of billing your insurance company on your behalf and will accept payment from them directly but any monies owed on your account are ultimately your responsibility per the financial agreement you signed. The clinic can not be responsible for disputing or appealing the way your insurance has processed payment on a claim. In the event we are not paid in full by your insurance company (less any contractual write offs we are to take with insurances we are contracted with) you will be balanced billed any remaining charges after your insurance has addressed a claim and required to pay us directly and work out your difficulties with your insurance carrier.
Medicare Non-Covered Services
According to existing Medicare law, most of the services in our office are NON-COVERED and are the responsibility of the patient. Hopefully, the U.S. Congress will change that someday and treat Doctors of Chiropractic like all other doctors. Until then, here is a summary:
EXAMPLES OF NON-COVERED SERVICES
All Services Other than Chiropractic Adjustments:
- Office Visits- to evaluate and manage, re-evaluate, advise, or give counsel regarding your health.
- Physiotherapy- such as massage, traction, electrical stimulation, neuromuscular re-education, etc.
- X-rays, Laboratory, Supplies, Vitamins, etc.
Various Chiropractic Adjustments or Treatments:
- Non-spinal manipulation to the shoulder, arm, leg, etc.
- Maintenance Care- you are stable and not making any more improvement.
- Wellness Care – to promote health.
Claims billed to private insurance are due in full within sixty (60) days after your primary and or secondary insurance has been billed. Any worker’s compensation and or motor vehicle claims that are denied by the insurance carrier will become due in full once our office receives an official denial of the claim.
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