Office Policies Regarding Insurance and Finances

Chiropractic services are covered by most insurances, however, what and how much insurance coverage you may have varies from plan to plan.

Our relationship is with you. We do not have the direct relationship with your insurance company that you do. We interact (participate) with them as a courtesy to you. Ultimately you are financially responsible for any and all charges incurred at this office, including care when no insurance coverage is available, and/or co-payments, deductibles, and charges denied or not covered by your insurance company.

We participate with: Aetna, ASH Network, BCBS (out of state plans are generally covered through our region's Excellus plan), Cigna, Empire Plan, Excellus, GHI, MPN, No-Fault, OptumHealth, POMCO, RMSCO, Triad, United Health Care, and Worker's Compensation. We bill Medicare (for you) as non-participating providers which allows us a slightly higher reimbursement. Many of our Medicare patients pay only a co-pay and others are reimbursed through Medicare for up to 2/3 of the fee, generally within a couple of weeks.

It is your responsibility to be familiar with your insurance policy and requirements, and to know if the doctors in this office are participating or NON-participating providers with your insurance plan. We participate with most of the plans in our region. If we are non-participating either we had so much trouble with the plan when we were "par" that we eventually shifted to "non-par" status, or it is an insurance plan we have not applied to for a variety of reasons (some charge a huge fee to credential and have few members in our region, some panels are closed to new providers yet require all the doctors in the group to be par or none can, etc.). If we do not par with your plan and you would like us to look into it further just let us know.

Obtaining a primary care referral, if your plan requires it, is your responsibility; failure to do so will make you accountable for the entire bill if your insurance company denies care and/or refuses to pay, due to lack of a referral. POMCO and a few of the Excellus plans fall into this category.

Your care may be subject to “pre-authorization” by your insurance company; and, even though we document medical necessity, you accept all responsibility for any treatment that is deemed to be “not medically necessary” by your insurance carrier. Your insurer may not cover routine maintenance, preventive, OR wellness visits.

Many of our patients pay cash for all or the portion of their treatment plan outside the limits of their insurance coverage. Our fees are affordable and very reasonable for the levels of service we provide. We aim to give you "more than your money's worth". We offer pre-paid 'fee for service' plans for cash patients with free visits tagged onto the end, i.e. buy 12 visits as a package and get three more office visits free. This is called our HMA Package. Call or ask at the front desk for more details about it.

Chiropractic care is one of the most affordable forms of health care available. We look forward to working with you!