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HOW DOES MY INSURANCE WORK?

HOW DOES MY INSURANCE WORK?

  1. Does it cover Chiropractic and Therapies (manual muscle therapy, electric stimulation, kinesiotaping, craniopathy treatments, acupuncture, neurological exercises, nutritional counseling)?

 

Most insurance plans cover Chiropractic.  State Funded (Medicare, Medicaid, UCare, MNCare) typically ONLY cover SPINAL MANIPULATION (not extremities—knees, ankle, shoulders, elbows) and DO NOT cover any therapies.  If that is a necessary method to get you better, then that expense will be paid by the patient. Patients are best to check with their insurance to see if they cover physiotherapies.  We will check online and call your insurance, however, we have found that insurances like to make a small print at the bottom line that states that calling and looking up online does not guarantee payment.

 

  1. Do you have a DEDUCTIBLE?

How Does My Insurance Work?

If you have a deductible, insurances will not allow any payment to us until the deductible is met.  However, a few insurances do offer the first 1-3 treatments before they switch to the deductible amount.  Well checks for newborns are often covered without needing to meet the deductible.  Again call to find out for sure.

 

  1. Do you have a COPAY?

 

A copay is a set amount that the insurance company has determined that you will pay per office visit.  It typically ranges from $3 to $50.  Chiropractic is typically listed as a specialty office visit copay.  This amount must be collected whether or not your deductible has been met.

 

  1. Do you have a CO-INSURANCE?

 

A co-insurance is a percentage of the total bill that the insurance has determined you will pay.  This typically takes effect after the deductible is met and is often denoted at 20%/80%.  This means that the insurance picks up 80% of the total allowable amount, and you are responsible for 20%.  It often takes us multiple weeks or months to receive a notice and payment from your insurance that determines what the co-insurance exactly is.

  1. How we bill insurances:

 

At Cannon Pointe Chiropractic we are IN-NETWORK with nearly every insurance company.  This means you will get the best possible coverage out there.  You will typically have lower deductibles, lower copays, and lower co-insurances IN-NETWORK vs OUT-OF-NETWORK.  By being IN-NETWORK, we have agreed with the insurance company to accept a lowered payment schedule to better benefit our patients.  However, every insurance company pay differently, but we are legally unable to charge different amounts to different companies for the same services.  So, we have set our prices at the recommended allowable amounts by the MN Workers’ Compensation Fee Schedule.  These prices are often higher than the allowable amount by the insurance, and thus will not be collected.  Don’t panic if you receive a notice from your insurance company with a ridiculously high amount.  We will never collect that amount, and you will never pay out of pocket more than our cash price ($40 for an adjustment without any therapies, $45 for an adjustment with therapies, and $105 for an initial exam/consultation with an adjustment plus therapies).

 

  1. What about AUTO ACCIDENTS and WORKERS’ COMPENSATION CASES?

 

Under MN law, no fault auto insurance covers 100% of your expenses after injury due to an auto accident.  You have no deductible, but you may have a maximum benefit amount (often $40,000 or $80,000).  We always recommend that EVERYONE IN AN AUTO ACCIDENT, NO MATTER HOW INSIGNIFICANT IT MAY SEEM, be checked out through their Auto Insurance.  Often injuries are not noticeable for multiple days to weeks after an accident.  Also, so many people think that the soreness and pain will go away on its own.  If you wait an extended period of time after an injury (auto or work), your insurance company has a much higher chance of COMPLETELY DENYING that they should pay for your care.  This means that YOU WILL BE RESPONSIBLE FOR ANY AND ALL PAYMENTS OUT OF POCKET OR THROUGH YOUR PERSONAL HEALTH INSURANCE.  This means you have to meet your deductible, copay, and co-insurance.

 

  1. SPECIFIC INSURANCE CASES?

We often run into the problem where an insurance company will not pay because they are “waiting on information from the member.”  This means that they have sent you a letter that wants you to answer if any of the treatment you are receiving is due to an auto or work injury.  If you answer that is it due to one of these events, YOUR INSURANCE IS NOT RESPONSIBLE TO PAY!  If you do not send this form in, we cannot process your bills through your insurance and you will be billed.  At this point we are required to bill you for the full amount. We will contact you if we repeatedly get this message from your insurance.  If you have not received this notice or have lost it, you must call your customer service to take care of the matter.

We take almost ALL insurances!

  • Blue Cross and Blue Shield
  • Medica
  • Medicare
    • Any supplemental insurance through Medicare including Humana
  • Medicaid
  • United Healthcare
  • Preferred One
  • Aetna
  • Cigna
  • UCARE
  • Health Partners
  • Worker’s Comp Ins
    • Getting hurt at work
  • Personal Injury insurance
    • Hurt in a car accident