Morris Chiropractic is a network provider for the following insurance plans:
- United Healthcare
- All automobile insurance plans
Determining your financial responsibility
Insurance can be confusing! While we will contact your insurance to determine your financial responsibility, the information we receive is accompanied by the disclaimer "this information is not a guarantee of benefits or payment"(their words, not ours!). For this reason we encourage our patients to contact the member services number on the back of their insurance card and ask the following questions:
- What is my copay for a chiropractic visit?
- Will this visit be applied to my deductible?
- On my first visit, the chiropractor will conduct a new patient exam. Is there an extra copay for this exam?
- On my first visit, the chiropractor may need to do x-rays. Are plain film x-rays included in my copay or will these be applied to my deductible?
- Depending on my condition, my chiropractor may perform physical therapy during my visits as part of my treatment. Is physical therapy included in my copay or will this be applied to my deductible?
- Does my plan require prior authorization for chiropractic care?
- How many visits are allowed per year?
Our office will be glad to work with you to make sure you are fully informed about the cost of care, unfortunately, it is our experience that claims processing does not always match the benefit quote. The patient is responsible for all amounts designated as Patient Responsibility (copay, deductible, etc.) as determined by the final claim statement provided by the insurance company.
Payment for your estimated financial responsibility is due at the time of service.
If your insurance card says HMO, most likely you will need a referral from your primary care doctor to access the chiropractic benefits listed in your policy. Our office is unable to obtain referrals, you must contact your doctor to request a referral prior to your visit.
Prior Authorization required by some insurance plans
Some insurance plans require prior authorization before they will cover your treatment. Our office will complete the insurance forms and communicate this information to the insurance company. The insurance company will then decide if chiropractic care will be a covered service under your policy.
Due to the extensive amount of paperwork necessary to obtain prior authorization, our office does not appeal adverse decisions when an insurance company denies authorization for care.
Please note that if your insurance company says you do not need chiropractic care, this does not mean you cannot obtain chiropractic care outside of your policy. Our office will gladly see you on a cash basis.
No insurance (or really bad insurance)?
Morris Chiropractic accepts patients without insurance. Our cash price is structured to enable you to receive care without an excessive financial burden.
Please note that if you have a high deductible plan and choose to pay for your care on a cash basis, our office will track that care on a "bundled" code that may not be eligible for reimbursement from your plan.
Wellness Care - additional insurance coverage criteria
Insurance will only cover chiropractic care when you have an acute event that requires a series of treatments to return you to your pre-injury physical state. According to most plans, treatment is covered when there is a defined acute or initial therapeutic care plan with a goal of improvement in the functional status of the patient.
Although your chiropractor will advocate Wellness care - regular treatments, usually on a monthly basis, to maintain a healthy spine, this is not a covered service under most insurance plans.
Wellness (also known as maintenance or preventive care) is defined by insurance as:
- typically rendered on a regular or periodic basis to help maintain optimal body function, often when there is little or no activity-restricting symptoms
- when the functional status of the patient becomes stable for a given illness/condition/injury without functional improvement in the member’s net health outcome or expectation of measurable clinical improvement
- when symptoms have become stationary after the completion of an initial course of therapeutic care
- when treatment is not expected to provide further measureable functional improvement in the patient’s condition
- for treatment of unresolved, recurrent, or chronic conditions including chronic spinal subluxation
- when the patient’s condition has stabilized or reached a clinical plateau
Think of it like taking care of your car. If you are in an accident and your car gets damaged, your automobile insurance will cover the restoration of your car. Normal maintenance, like changing the oil to keep your car at peak performance, is not covered by insurance.
We encourage our patients to keep a regular schedule of Wellness care and strive to make that care affordable outside of insurance coverage. Wellness care may be reimbursable under H S A or flex spending accounts – check with your plan administrator for details.
Most of us take better care of our automobiles than our bodies . . . yet the auto has replaceable parts.
~ B. J. Palmer
Kentucky is a no-fault state. Your automobile insurance will pay your medical claims, then collect that money from the other party's insurance company.
If the cost of your care exceeds the amount of Personal Injury Protection purchased as part of your insurance policy, excess medical bills will be paid as part of a final settlement with the at-fault party.
If you have been injured in an automobile accident, please seek treatment as soon as possible. In our experience, the most common reason an insurance company will use to deny a claim is a delay in seeking treatment. Their logic stands as "if the patient was actually hurt as a result of the accident, he or she would have seen a doctor immediately".
Our office will require the following information to request payment from your automobile insurance for your care:
- The name of your insurance company
- The name and contact information for your claims adjuster
- The address or fax number used to submit claims
- Your claim number
On your first visit you will be asked to sign a Medical Lien form. This form will direct your insurance company, the other party's insurance company and your attorney to reimburse our office for the care your receive. We have seen cases where an insurance company will offer a settlement without telling the patient that he or she must pay their own bills out of the settlement. The medical lien will protect you from this unpleasant surprise.
While our office cannot recommend an attorney, if your medical bills exceed your PIP coverage, you are strongly encouraged to obtain legal representation to help settle your claim. Upon receipt of your signed authorization we will maintain open communication with your attorney and keep him apprised of your care.