WHAT ARE THE FEES?
It’s $50 for the first visit, $48 for follow up visits.
That’s what you want to remember.
We’re going to give you as honest of an answer as we can, but the answer for most of you will be “it depends upon your insurance.”
Be prepared for $50 for the first visit and $48 for follow ups, but depending upon your insurance, it could be less, but it won’t be more. Exceptions to this are Zoom/telephone consultations which are $75.
WHAT ABOUT INSURANCE?
Your insurance plan may have a copay or percentage that you pay. This can range between zero-$60. Simply put, the more you or your employer pays for insurance, the better the policy. Plan on the $50 for the first visit/$48 for follow ups. When you come in for your appointment, the staff will check your insurance policy. If it’s less than $50/$48 then you pay the lower amount copay. This applies to services when you pay at the time of service. Insurance companies do NOT pay us based upon what we charge, they pay us based upon a discounted or “allowable amount.” We itemize our services and thus what we charge (say $186) may be reduced to $71.18. If you have a to pay 10%, that means YOU pay $7.12, or if you have to pay 20%, it would be $14.24… significantly lower than $48. This applies to all doctors that you see on your insurance plan.
KAISER, ANTHEM, AND BLUE SHIELD
There are some insurance companies that use “middle men” such as Kaiser, Anthem, and Blue Shield to process their claims. It’s not all the policies, but some. This is done to save money for the insurance company, but it can be confusing to a patient because while you may feel that you have Kaiser, Kaiser doesn’t pay us (even though we’re contracted with Kaiser). It’s the contracted company that pays us.
These companies may have copays but they disallow the doctor from doing certain services. This is the method to keep costs for them down. It’s similar to your dental insurance company paying for cleanings, x-rays, but not teeth whitening. Again, plan on $50/$48 at worse or less money as the best case scenario.
MEDICARE
Medicare is similar as they are a limiting policy that does not pay for all the services a chiropractor may do. Plan on $50 for the first visit, $48 for follow ups. It may be less depending upon your secondary policy, but we’ll know when we can confirm this. It may be less, but it won’t be more.
CAR ACCIDENTS
Car accident cases are handled in two ways.
- If you have a Med-Pay policy, we will bill your insurance our normal itemized rates, however the Med-Pay policy will often use insurance rates to determine the “allowable” or discounted amounts. So while we may bill $186 for example, we may only receive $70. It’s not what we charge that matters, it’s what they allow. With most Med-Pay, you will likely pay nothing.
- If you have an attorney (we do accept liens), we will bill our normal itemized rates and hope that your attorney wins the case. Often in car accidents, there is never a situation where an attorney “wins the case” but it’s rather a negotiation where both parties agree to settle on a amount of money and the attorney often will offer us a percentage of what we charge, based upon a multitude of factors (car damage, policy limits of the insured, etc). Car accident cases often don't get settled for years after we finish treating you.
WHY DOCTORS WON’T GIVE ME A STRAIGHT ANSWER
Healthcare is one of the funniest professions. Have you ever tried to ask your own doctor or a hospital “How much does this cost?”
It’s almost as if they REFUSE to tell you.
Imagine a restaurant refusing to tell you what the hamburger costs until after you eat it, or buying bread at the supermarket and them telling you, “We’ll bill you.”
Sounds silly but that’s exactly what healthcare is like. There are some offices that will offer a FREE consultation to get you into the office to "sell" you a package deal (sometimes in the thousands of dollars). We DO NOT DO THIS.
This is why we’re trying to be upfront and transparent about our fees.
Call our office at (805) 389-0325