Health insurance for chiropractic

Health insurance

The first question patients may ask when they call into our office is usually “Do you accept my insurance?”  With the affordable care act, everyone is required to have health insurance, so most people want to take advantage of a service for which they are already paying.

In our office, we are in network with Blue cross/Blue shield, Aetna, United, and Medicare. Insurance plans are usually categorized as PPO or HMO - and we only participate in PPO Plans.  You can learn more about the difference between these two types of plans here

What do you need to know to actually understand how much your visit will cost? Just a handful of details. First, you need to know your plan’s benefits. Second, you need to understand how medical services get billed. Lastly, you need to understand Insurance reimbursement policies.  

So, let’s start with benefits. With the internet it becomes easier each year for patients and doctors alike to check an insurance plan’s benefits. It is important to understand your premium, deductible, out of pocket maximum, CoPays and CoInsurance rates. But getting a list of prices for those benefits is meaningless if you don’t understand what each term means, so check out our other blog post on that topic if you haven’t already. We go over these values and their definitions with every new patient. 

Now that you know your plans benefit details, how do chiropractic offices and other healthcare facilities bill for their services? American healthcare uses a fee for service model.  This means when a doctor performs a healthcare service, they bill the insurance and/or patient for that service. This means doctors, hospitals, and chiropractors get paid based on what they do, and how much of it they do for you. (This opens up several ethical dilemmas, but that may be a better topic for another blog post) 

In our West Loop office, we perform anywhere from 1-4 services per visit. To learn more about our office's specific billing practice, you can visit our blog post on that specific topic >>here<<. The most common services performed in our office are patient exams, chiropractic adjustments, physical therapy, and manual therapy (such as myofascial release or dry needling). 

Lastly, let’s talk rates. One thing that frustrates doctors and patients alike is that it is often impossible to determine with 100% accuracy how much a visit will cost and how much of a visit an insurance company will cover. The two main reasons for that are that 1) Your doctor/chiropractor doesn’t know exactly what services you will require until they understand your problem and have a plan to treat it, and 2) different plans have different negotiated rates with providers, which means even two people with the same insurance company might pay slightly different rates. You can learn more about it here.

Hopefully that helps you understand you health insurance plan. If you’ve still got questions, we’re always willing to help explain, especially when you received a bill you don’t understand.  Please don’t hesitate to call in or stop by when you’re in the West Loop!

 

Author
Dr. Todd Peterson, DC, Cert MDT. Dr. Todd Peteson Dr. Todd Peterson is a chiropractor and certified provider for Mechanical Diagnosis & Therapy (MDT, aka the McKenzie Method). Dr. Peterson played football at the University of Nebraska, where he was a 4 year letter winner and Academic All American. He briefly played professional football in 2009 before returning to Chiropractic School in 2010. He earned his doctor of chiropractic (DC) degree from National University of Health Sciences in 2013, graduating with Magna Cum Laude honors.

You Might Also Enjoy...

The myths around cervical curvature

“Loss of cervical curvature” is one of the most common findings chiropractors use to explain neck pain and warn you of bad things to come. Come read this post to find out why that is not actually the case.

Anatomy is overrated.

What have you been told is the source of your pain? A bone out of place? A short leg? A straight curve? Arthritis? A tear in a tendon? In this post we discuss what really causes your pain and how inaccurate labels for pain can be a barrier to recovery.

What to expect on your first visit

We’ve had a lot of questions from potential patients recently about what to expect on the first day they come into the office, so this blog post is here to lay out what happens during a new patient visit.

Why Do we use the McKenzie method?`

The McKenzie method, or Mechanical Diagnosis and Therapy (AKA MDT) is a method we use to assess every patient who walks in our doors with joint or body pain. In this post, we go over reasons why we think it is the best approach for patients in pain.

Handheld Massagers

Handheld percussive devices are gaining popularity fast. Come in this post to see what they do, what they don't, and how we chose the right device for our office.

To Adjust or not to adjust?

A chiropractic adjustment is a powerful tool for joint healing. But it's not for everyone, every time. Come find out how we decide if, when, and where to adjust.