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What will your insurance cover?

All major medical policies from all companies (such as the coverage you get through an employer-sponsored plan) are decreasing their coverage on inexpensive types of outpatient healthcare including chiropractic, physical therapy, etc. Common deductibles of $500 or more effectively eliminate chiropractic coverage.

Here is a brief overview of the coverage for an in-network chiropractor from all well-known insurance carriers:

  • Your plan will cover 5 to 6 office visits at your copayment. The copayment amount is probably not what you pay to see a PCP; it will be what you pay to see a specialist. Your provider might get permission to treat for another 4 to 5 office visits. For more treatment to be eligible for coverage, you will have to have a new injury or problem with a new diagnosis. It does not matter how many visits your plan says it covers per year; that is what the insurance company sold to the employer. The treatment authorization and payments are controlled by third-party administrators who cut expenses any way they can in order to justify their arrangement with the insurance company.
  • If you choose to see a chiropractor for periodic maintenance, wellness, or preventive care, you are making a wise decision. These are the most underutilized applications of chiropractic and will save you time and money in the future. However, your insurance company will only cover crisis care.
  • Any visits you see the provider for that are denied for any reason, often arbitrary, can be billed to you at their normal fee structure.
  • The combination of the patient copayment and the amount that the company pays the provider has become so low that it is sometimes below the cost of doing business. For this reason, the best and most experienced chiropractors I know are dropping out of network with most or all major medical insurance carriers.
  • Paperwork required to be filled out by in-network providers and patients is oppressive; with unrealistic requirements such as same-day filing, and arbitrary documentation requirements.

For the reasons listed above, we are not in-network providers for any insurance company. We will file on out-of-network coverage, which if available does not have as many restrictions, or assist you in filing. We do file on medical payment coverage for auto accident patients. In addition, if you were injured in an auto accident and do not have medical payments coverage, we can work with you if the accident was not your fault. Otherwise we have a very fair fee structure for those paying themselves which is lower than the fees of MDs, dentists, podiatrists, and other doctors. Chiropractic is safe and cost-effective; the best value of the healthcare professions.

We specialize in sending out a minimum of bills. No one likes surprise bills in the mail. This is accomplished through good communication, understanding what insurance does and does not cover, and patient cooperation. Sometimes patients must call their company; they not us are the customer of the insurance company.

Thanks for visiting our site. We look forward to meeting with you in person and learning how chiropractic can fit into your health care goals. Give our Suwanee chiropractic office a call or click here to email us and we can arrange a time to explore your options!

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Office Hours

Please call us at 770-904-3772 to schedule an appointment.

Monday:            9:00am – 1:00pm; 3:00pm – 7:00pm

Tuesday:            9:00am – 12:00pm (Appointment Only)

Wednesday:      9:00am – 1:00pm; 3:00pm – 7:00pm

Thursday:          9:00am – 12:00pm (Appointment Only)

Friday:               9:00am – 3:00pm

Saturday:          9:00am – 12:00pm (Appointment Only)

Sunday:             CLOSED