Skip to content

FINANCIAL AGREEMENT

MAJOR MEDICAL GROUP HEALTH INSURANCE/ MEDICARE

Explanation of Benefits

We are in network with most major medical insurance companies; all of which have a variety of policies with either deductibles or co-pays. How much a patient will pay per visit is based on their individual insurance coverage. The payment will be determined when we verify benefits through the insurance company. The only time we will alter what is collected is if the Explanation of Benefits (which is sent with payment from the insurance company) shows a discrepancy.

Insurance Specifics

In our attempt to provide our patients with the best chiropractic care at an affordable fee, we agree to certain procedures regarding insurance payments. We can, however, only start billing insurance carriers after completion of the following:

  1. We have a copy of patient’s CURRENT insurance card.
  2. Insurance coverage is verified by our office.
  3. An Insurance Verification form is signed by the patient.
  4. Any pre-authorization needed for treatment must be obtained prior to service.
  5. If the insurance carrier informs us that a patient is under a pre-existing waiting period; payment must be made in full at time of service. We will still bill the insurance carrier as a courtesy. When the pre-existing waiting period is over, the patient will be charged the co-pay, coinsurance, or deductibleper insurance benefits.

Once coverage has been verified that chiropractic care is a covered benefit, it is the policy of our office to accept assignment, therefore, lessening the out of pocket expense. Anything the insurance carrier does not cover such as therapies or supplies will be the patient’s responsibility. Some insurance companies like Medicare and Blue Cross/Blue Shield occasionally send payment to the patient directly. If you receive a check from your insurance carrier, make sure you bring the check to us with the attached explanation of benefits. Failure to forward all payments rightfully due this office constitutes fraud, and the appropriate action will be taken. Billing the insurance carrier directly and accepting assignment of benefits is only a courtesy extended by this office. In no way does this lessen the patient’s obligation of any charges not paid by the insurance carrier. All unpaid charges are ultimately the patient’s responsibility.

PATIENT PAYMENT

Payments may be made by cash, check, Visa, MasterCard, and American Express. The patient is responsible for paying their deductible, coinsurance, and co-payments at time of service. Therapies and x-rays that are not covered by the insurance carrier must be paid in full at time of service. There is a $25.00 fee for FMLA forms, disability forms, and medical record copies. There is a $30.00 fee for returned checks. Accounts with outstanding balances will be turned into collections.

Call today to schedule your appointment or ask questions.