Insurance And Billing

At our Portland Chiropractic office, we strive to provide exceptional care while ensuring a transparent and seamless insurance and billing process for our patients. On this page, we will discuss our courtesy billing practices, patient responsibilities, benefit verifications, insurance networks, billing Medicare, copays vs. co-insurances, services subject to deductibles, insurance coverage limitations, and alternative options for uninsured patients.

Courtesy Billing: Simplifying Insurance Claims

  • We understand the complexities of insurance billing and strive to alleviate our patients’ administrative burdens.
  • As a courtesy, we handle billing processes by submitting claims to insurance companies on behalf of our patients.
  • This service allows patients to focus on their treatment while we handle the insurance paperwork.

Patient Responsibilities: Copays and Co-insurances

  • While we assist with billing insurance, it is important for patients to understand their financial responsibilities.
  • Copays and co-insurances are the patient’s responsibility and are expected to be paid at the time of service.
  • These payments contribute to the overall cost of treatment and are typically specified in the patient’s insurance plan.

Courtesy Benefit Verifications: Empowering Patients

  • We provide courtesy benefit verifications to help patients understand their out-of-pocket costs before their visit.
  • However, this service relies on patients providing their insurance information to us in advance.
  • Patients are ultimately responsible for knowing their insurance benefits, and our verifications serve as a helpful aid.

Contacting Insurance Companies: Ensuring Coverage Information

  • Patients should proactively contact their insurance companies before their appointment to understand their coverage.
  • Although we strive to provide timely benefit verifications, they may not always be available before the appointment.
  • Directly contacting insurance providers ensures the most up-to-date information regarding coverage and benefits.

Insurance Networks

We are in network with the following insurance networks

  • Moda
  • Cigna (limited to chiropractic care only)
  • Providence
  • BCBS (Blue Cross Blue Shield)
  • Kaiser CHP (limited to chiropractic care only)

We are not in network with the following insurance companies

  • OHP (Oregon Health Plan)
  • United Health Care
  • Aetna

Medicare Coverage and Limitations

  • Medicare covers subluxation of the spine; however, if patients desire additional modalities during treatment, they may need to pay out of pocket.
  • Currently, we are unable to bill Medicare, which means we cannot bill secondary insurance to Medicare until our contract with Medicare is finalized.
  • Patients with Medicare should be aware of these limitations and discuss treatment options with our staff.

Understanding Copays and Co-insurances

  • Copays are fixed amounts that patients pay at the time of service.
  • Co-insurances are a percentage of the total cost of treatment that patients are responsible for paying.
  • Patients should consult their insurance plan to determine the specific amounts of copays and coinsurances they are expected to pay.

Services Subject to Deductibles

  • If a patient’s insurance benefits are subject to a deductible, they will be responsible for the entire out-of-pocket amount for services until the deductible is met.
  • Patients should review their insurance plan to understand the deductible requirements and how they affect their financial responsibility.

Insurance Coverage Limitations

  • We offer various services during treatment, which may result in additional copays or coinsurances, as stipulated by the patient’s insurance plan.
  • We do not have control over what services are covered by insurance. If patients have questions about coverage, it is best to contact their insurance provider directly.

Keeping Insurance Information Updated

  • It is crucial for patients to inform us promptly if they have new insurance to avoid confusion during the billing process.
  • Timely updates help us ensure accurate billing for treatment and avoid any potential complications.

Alternative Option - ChiroHealth USA

  • We offer an alternative to insurance through the ChiroHealth USA program.
  • ChiroHealth USA is a membership program available for $49, providing access to discounted chiropractic services for 12 months.
  • This program is particularly beneficial for patients with high deductibles, no insurance, or out-of-network insurance.

Conclusion

At our chiropractic office, we prioritize providing quality care while simplifying the insurance and billing process for our patients. We offer courtesy billing services, but patients are responsible for copays and co-insurances. Our courtesy benefit verifications assist patients in understanding their out-of-pocket costs, but it depends on timely insurance information. Patients should contact their insurance companies for coverage details and update us with any changes to their insurance. We do our best to provide accurate representations of insurance benefits, and for uninsured patients or those seeking alternative options, ChiroHealth USA offers discounted services. If patients have questions about coverage or billing, contacting their insurance providers directly is the most reliable way to get comprehensive answers.