Insurance

 

The Insurance Facts:

Health insurance is playing an increasing role in helping people obtain chiropractic and medical treatment.  We feel that our patients deserve the best possible chiropractic care we can provide.  In an effort to maintain our high quality of care, we would like to share some health insurance facts with you.

FACT:             Health insurance in NOT a PAY-ALL; it is only meant to be an aid.

 

FACT:             Many insurance companies tell the patient they will be covered “70%, 80% or up to 100%.”

We have found that most insurance plans cover approximately 50% of an average treatment program.  Some plans pay more, some less.  Usually, the amount your plan pays is determined by how much your employer paid for the plan.

 

FACT:             Insurance companies usually tell the patient the doctor’s “fees are above the usual and

customary allowed”, rather than saying “your benefits are too low”.

 

FACT:             Many times insurance companies will deny services stating “the services provided were

not medically necessary”, rather than saying “the limitations of the policy have been

reached.”  It is interesting that an insurance company can determine medical necessity

without reviewing office notes, examination the patient or discussing the patient’s

condition with the treating doctor.

 

FACT:              Each insurance company has its own set of rules for filing insurance claims, and they

don’t want you to know what they are.  It has been my own personal experience that

insurance companies will deny services that should have been covered in hopes that

you, the patient, does not understand your policy and will pay out of your own pocket. 

Familiarize yourself with your policy and stand up to the insurance companies if they

deny services that you feel be covered.

 

Please do not let your insurance coverage dictate the treatment you need to correct and maintain your health.  If finances are an obstacle, please discuss it with our friendly, trained staff.  We have payments plans to fit almost any budget.

 

OUR BILLING POLICY

 

As a courtesy to our patients, we have full-time insurance department located at our Federal Way office.  We file claims on a weekly basis and we will assist you with any insurance questions you may have.

 

HMO’S, PPO’S & PATIENT WOES

 

Health care has been making rapid changes in recent years.  Insurance companies have formed HMO’s, PPO’s, utilize 3rd parties to manage chiropractic claims, and other networks of doctors in order to control health care costs.

 

We may or may not be a provider in your particular group.  Many policies allow coverage for “out of network” providers payable at a different rate.   We will work with your primary care provider and your insurance company in order for you to obtain the maximum benefits allowed.

 

The following are a few of the insurance plans that we are preferred providers for:

  • Regence
  • Blue Cross/Blue Shield
  • Aetna PPO
  • Cigna PPO
  • First Choice
  • Pacificare
  • United Health Care (company specific)
  • + many others