INSURANCE COMPANY PARTICULARS
Insurance plans are quite varied. Your plan is a special agreement you made with your company, be sure to familiarize yourself with the requirements of your plan: plans vary significantly!
BILLING
Billing insurance on your behalf requires your insurance card on you on your first visit. With the personal information you provide plus insurance card information, we are able to bill your company quickly and efficiently. Our system is capable of billing all insurance carriers.
TYPES OF INSURANCE In Network, Out of Network
Plans generally have either a patient co-pay amount for providers on their list ( in their network), or a percentage (%) for providers not on their list. For example: a co-pay amount may be $15.00 for a $60.00 office visit, whereas the percentage amount (usually 80/20) would be $12.00. Provisions can be different for each type of care, so familiarize yourself with your plan.
LIMITS OF CARE
Often, insurance companies limit patient care for in-network providers (on their list). For example they may only allow 5 visits for chiropractic services per year, 5 massage therapy visits, etc., whereas out of network providers (not on their list) generally are reimbursed at a percentage of services rendered. Check your plan.
Some plans restrict care to only providers on their list. Therefore it is important that you know your policy provision, and your reimbursement schedule.
PROVIDER CLOSED LIST
Insurance companies often have a 'closed' panel. That means the company only allows certain providers to be on their list and no more. This is not because of professional competence as it would be illegal for an insurance company to choose one provider over another when the state judged competency by issuing a license to practice.
DEDUCTIBLE
Besides the amount due per visit, insurance companies generally have a deductible that must be met. This is money paid to the provider before the insurance company considers reimbursement for your claim.
INSURANCE OR NOT ?
In many cases, after the insurance monthly fee is added to the deductible and amount of payment for a service it is cheaper to pay cash, especially if a cash discount is offered.
The advantages of not using insurance is there is no third party with ongoing access to your private health information, there is no insurance risk assessment that could later restrict your coverage, there is no restrictions to services available, and you are free to go to the provider of your choice.
Our opinion is that insurance is usually best when used for high dollar services like surgery, extensive procedures, etc.
OFFICE POLICY
We bill your insurance provider for you, but require payment for services when the services are rendered. This approach lowers our administrative costs and is why we can keep fees low. Our experience is the insurance company responds quicker when required to reimburse the patient.
Insurance plans are quite varied. Your plan is a special agreement you made with your company, be sure to familiarize yourself with the requirements of your plan: plans vary significantly!
BILLING
Billing insurance on your behalf requires your insurance card on you on your first visit. With the personal information you provide plus insurance card information, we are able to bill your company quickly and efficiently. Our system is capable of billing all insurance carriers.
TYPES OF INSURANCE In Network, Out of Network
Plans generally have either a patient co-pay amount for providers on their list ( in their network), or a percentage (%) for providers not on their list. For example: a co-pay amount may be $15.00 for a $60.00 office visit, whereas the percentage amount (usually 80/20) would be $12.00. Provisions can be different for each type of care, so familiarize yourself with your plan.
LIMITS OF CARE
Often, insurance companies limit patient care for in-network providers (on their list). For example they may only allow 5 visits for chiropractic services per year, 5 massage therapy visits, etc., whereas out of network providers (not on their list) generally are reimbursed at a percentage of services rendered. Check your plan.
Some plans restrict care to only providers on their list. Therefore it is important that you know your policy provision, and your reimbursement schedule.
PROVIDER CLOSED LIST
Insurance companies often have a 'closed' panel. That means the company only allows certain providers to be on their list and no more. This is not because of professional competence as it would be illegal for an insurance company to choose one provider over another when the state judged competency by issuing a license to practice.
DEDUCTIBLE
Besides the amount due per visit, insurance companies generally have a deductible that must be met. This is money paid to the provider before the insurance company considers reimbursement for your claim.
INSURANCE OR NOT ?
In many cases, after the insurance monthly fee is added to the deductible and amount of payment for a service it is cheaper to pay cash, especially if a cash discount is offered.
The advantages of not using insurance is there is no third party with ongoing access to your private health information, there is no insurance risk assessment that could later restrict your coverage, there is no restrictions to services available, and you are free to go to the provider of your choice.
Our opinion is that insurance is usually best when used for high dollar services like surgery, extensive procedures, etc.
OFFICE POLICY
We bill your insurance provider for you, but require payment for services when the services are rendered. This approach lowers our administrative costs and is why we can keep fees low. Our experience is the insurance company responds quicker when required to reimburse the patient.
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