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The Top 8 Things We Want You To Know

About Your Health Insurance at The Chiropractors

by Ashley (New Patient Coordinator)

Whether you are a new patient or have been with us from the very beginning it’s always a good idea to understand how your health insurance works – and less stressful! Below are eight items I feel everyone should know and tips about their insurance coverage.

For New Patients: We check on your insurance for you the first day!Profile Pic of Ashley

We ask that patients bring in their insurance card to their first visit, and we take care of everything from there!  We check on eligibility for all of our services, and are able to give patients an accurate idea of what they can expect their treatment to cost.

We are in network with most insurance companies.

Including Blue Cross Blue Shield (PPO), Medicare, Healthlink, Coventry & Aetna.

We also accept Cigna and Health Alliance plans that have chiropractic coverage.

Most plans cover chiropractic and more!

A lot of people aren’t aware of how much their insurance actually covers!  Most plans not only cover chiropractic in our office, but a lot of our other services.  Massage therapy, corrective exercise/personal training and acupuncture are an example of some of them!

Most plans do not require a referral!

I know we are considered specialists, and I know most HMO plans require referrals but this is usually not the case!  State of Illinois employees with Healthlink and Coventry HMO plans are able to see us without getting any sort of referral.  The one plan that is the exception is Health Alliance HMO, but that’s where I come in!  Getting a referral is a pretty simple process, and I am here to help throughout.

What do these insurance terms mean?

A deductible is the amount the patient has to pay out of pocket before the insurance company will start to pay.  If a patient has a $500.00 deductible and 80% coverage, the patient would pay $500.00 before insurance would start picking up 80% of the cost.

Co-insurance is the portion of the visit cost that the patient has to pay for.  If your insurance covers at 80%, your co-insurance (or the amount that you would owe) would be the remaining 20%.

A co-pay is a flat rate that patients have to pay at each visit.  The important thing to consider when you have a copay is that since it is a flat rate, you may be able to get other services in the office (covered under that copay) for no additional cost!  For example, if your plan has a $20 copay and covers massage therapy and exercise in our office, you would be to get your adjustment, a massage and a session with our personal trainer all for the $20.00!  It’s important to know all of the things your copay covers, and again, that’s what I’m here for!

Explanation of Benefits is basically the term they use for insurance payments.  It is a breakdown of each date of service and what they did and did not cover.  It will include the portion they paid, the portion they wrote off and the portion that is due from the patient.

Look for your copies of Explanation of Benefits!

Our office handles all things insurance so you don’t have to.  We want you to be able to focus on your care and healing, instead of worrying about what the insurance is (or isn’t) doing.  However!  Insurance companies DO send out copies of explanation of benefits (or payment) to the patient and I HIGHLY recommend taking advantage of this!  I am of course always available to answer questions, but these will be really helpful for you to keep track of things throughout care.  Also, insurance companies have a tendency to change copays/deductibles each year, with or without letting plan-holders know.  These patient EOBs will keep you informed of your coverage and any changes that may have been made!

We do all of the coordination for Workers Compensation and Personal Injury claims.

Work or motor vehicle accidents are scary!  A lot of patients coming in following an accident are in that position for the first time, and it can be incredibly overwhelming.  The good news is, though, that it doesn’t have to be.  I handle all of the billing with these cases, coordinating with insurance adjustors and any attorneys the patient may be working with so the patient doesn’t have to. I want our patients to be focused on one thing, and that is getting and staying well!

Hopefully some of these tips have made insurance and how we bill in our office a little easier to understand!  As always, though, I am available to answer any questions patients might have throughout care!

Take Care – Ashley

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