We have prepared the following financial policy in order to help our patients determine their responsibility for payment of chiropractic and massage therapy services. Please check the box(s) that apply to you and sign at the bottom.
PAYMENT IS EXPECTED AT THE TIME SERVICES ARE RENDERED
HEALTH INSURANCE (Major Medical Coverage): Once insurance coverage is verified, we will be happy to bill your insurance company for you! You will be required to pay the amount not covered by your insurance company at each office visit.
- A Telephone quote usually is the way we obtain medical benefit and eligibility information however this does not necessarily mean your insurance company will approve treatment nor guarantee payment of services.
- There is a possibility your insurance company has a deductible; if this pertains to you then it is your responsibility to pay for any portion that your insurance company does not cover. You can make arrangements to make payments for your deductible, co-payments and any other portion your insurance company does not cover.
PERSONAL INJURY PROTECTION (PIP) AND AUTO ACCIDENTS: Cases will be billed directly to the insurance company, provided paperwork has been filled out correctly and claim has been filed.
- If auto accident was not your fault you still must notify your insurance company so they are aware of accident and can provide you with a claim number for your medical bills to be paid. This is a standard procedure with insurance companies; your insurance company will pay your medical bills up front and will be re-reimbursed from the at-fault insurance company when your claim is settled.
- Even if the other insurance company agrees to pay for your medical bills, they have no obligation to pay them, and will exercise that right leaving you responsible for your medical bills.
WORKERS COMPENSATION: Workers compensation claims will be billed directly to the insurance company, provided the paperwork has been filled out correctly and claims has been filed. IF YOU ARE DENIED WORKERS COMPENSATION, YOU WILL BE RESPONSIBLE FOR ALL BILLS INCURRED.
MEDICARE: Please be advised that Medicare-B will only pay for spinal adjustments and there is a 20% co-payment. THEY WILL NOT PAY FOR EXAMS AND X-RAYS.
PRIVATE PAY: If you do not have health insurance, you will be responsible for health care expenses and we will make sure your accounts are kept current or have made payment arrangements that are suitable for all parties.
- OUR OFFICE’S “CASH” FEES ARE POSSIBLE DUE TO THE MINIMAL AMOUNT OF PATIENT BILLING REQUIRED. WE ASK THAT YOU PLEASE HAVE YOUR PLAN AMOUNT READY ON THE DATE IT IS DUE.
- We will be periodically be updating our accounts so if there is any discrepancy we will let you now right away so you can keep your account current. If you have a credit balance, we will inform you, at which time you can request a refund or leave the credit to be applied to future charges.
We believe this is a clear definition of our financial policy and it will allow us all to continue to concentrate on the most important issue you health and well- being.