Answers to Your Insurance Questions
We welcome auto accident patients. Every case is different and you will need to check with your insurance carrier to see what your benefits are, and to whom you will need to send your receipts. Due to the poor reimbursement practices of the auto insurance companies, we do not file claims with auto insurance companies. Attorney liens are not accepted.
Auto accident patients pay out of pocket for all services received here at Bedford County Chiropractic. Payment is expected at the time services are rendered. Please ask any time you have questions about your care or your charges.
You have a Primary and a Secondary insurance. It must be filed in that order, even if your Primary Insurance is an Out-Of-Network plan. Your secondary insurance cannot be filed until your Primary insurance responds. Please bring in both cards.
There are so many variables with each insurance policy and they have strict rules about filing. If they send you a letter requesting information please send it back right away to assure smooth and prompt response to all your doctors. Your Doctor cannot get paid for services you have already received if you do not respond to the insurance company’s inquiries.
Each policy within the same network can be different from another plan. To check your benefits, turn your insurance card over and use the member or customer service phone number listed. Ask, “What are my In-Network Chiropractic benefits?”
Co-pays are often only applicable on your first visit: Exam and X-Rays. Co-pays range from $20-$45 when they apply. Deductibles vary and can range from $1,000 to $5,000 depending on the policy you have chosen.
Coverage varies so much, from 10 visits per year to unlimited. Some plans don’t count visits, but limit based upon their contribution, up to $1000 from BlueCross. Bedford County Chiropractic will verify your BlueCross BlueShield coverage when you present your card on your first visit. Please have it with you.
Yes. Plans “S”, “P”, “PPO” and “FEP”
but NOT their Medicare Advantage Plans; ie: BlueAdvantage
We welcome Medicare (MC) patients. However, we are not a Preferred Provider for Medicare. This means MC claims are filed as OUT OF NETWORK. Medicare coverage for Chiropractic care is very limited.
Mostly, No. If Medicare denies payment for a service, usually your Medigap-type insurance will also leave you with the responsibility to pay for that service. Secondary only covers the difference between the limited amount and the 80% mentioned earlier.
Secondary insurance (Medigap or the like) should be forwarded by Medicare automatically after Medicare processes their portion of the claim.
Reasons Medicare may not reimburse can range from “not medically necessary” to “not a valid condition”:(such as Maintenance Care), to any number of denial codes. If there is an error on our part, we will do our best to correct it and help you get reimbursed. Sometimes, if you are receiving care from another doctor or facility for a similar problem already, Medicare may make a determination that Chiropractic Services are not necessary and will therefore deny coverage.
That will depend on what services are rendered on any particular visit. If you have a question about the cost each time, be sure to ask the Doctor or one of the Front Desk Staff. You should receive an “ABN” which shows you acknowledge the charges for the day and understand you may not get reimbursed by Medicare.
No. You will get a small portion of your expenses back directly from Medicare, typically 3-6 months after your visit.
Medicare does not pay for Exams, X-rays, or Therapies. They do not pay for Foot Orthodics, Pillows, or analgesics even if recommended by the doctor.
The only thing Medicare reimburses you for is the Chiropractic Manipulation Therapy (CMT), known to many patients as the “Chiropractic Adjustment.”, and even then, only if Medicare approves the visit after it has been filed.
The claim is sent electronically to Medicare and IF they approve the services and charges, they will reimburse you, the patient, at home an amount that is 80% of a lower predetermined charge (making the reimbursement about $17.00). Reimbursement applies after any deductible requirements have been met.
Because we are out of network, Medicare patients pay out of pocket for all services received here at Bedford County Chiropractic. Payment plans can be arranged and all expenses will be explained to you. Please ask any time you have questions about your care or your charges.