Insurance Billing

Benefits

Insurance is confusing.  Reading an invoice from a chiropractor shouldn’t be.  We’re here to help with that problem today so that when you receive a bill from our West Loop office, you can go over it and understand what it means.

First, it’s important to understand how claims are sent to insurance companies.  Insurance companies pay for healthcare on a fee for service model.  That means that each service we provide has a contracted rate with the insurance company that both sides have agreed to pay and accept as payment.

Second, it’s important to realize when a service can be billed.  Some services, like examinations and adjustments, are encounter-based. This means that once they are performed, they can be billed, but can only be billed once per visit. 

On the other hand, certain services are time based. This means you must perform this service for a set amount of time, and if a time threshold is met, you can bill for the service.  These services come in units, and more than one unit may be performed in a day. This means there is also a timed threshold for a second, third, and so on.  This is most commonly the case in our office with myofascial release and physical therapy.. Timed units are no less than 8 minutes and no more than 15 minutes.  Therefore the minimum for 1 timed unit is 8 minutes, 2 is 23, 3 is 38, and so on. 

So what can you expect on our bills?

We provide 2-3 services per visit. This helps people get better faster.

There will be one code for an examination service on your first visit and any time you have a new problem.

There will be one code for a chiropractic adjustment if we performed a manipulation or joint mobilization. 

There may be one or more therapy codes depending on the time spent performing these therapies in office.

You will receive invoices for bills that are not covered by your insurance company via email.  If you click on the link in those emails, you will be able to see these charges line by line. 

If you have an unmet deductible, we may suggest you pay an estimated price for one service at the time of your visit. This helps decrease the liklihood of receiving a large lump sum bill at once. It is important to realize that because we may bill more than one service, this charge will not cover your entire visit. 

As always, if there is anything that you don't understand about your bill or insurance, don't hesitate to ask any one of our staff members. 

 

 

 

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.

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