Using private insurance
Most PPO plans include some chiropractic benefit, but coverage, deductibles and annual visit limits vary widely between plans. The quickest way to avoid surprises is to call the clinic's billing staff before your first visit and have your plan checked.
Before you come
Four things to confirm with your plan
- Does the plan include a chiropractic benefit, and at what level?
- Is there an annual visit limit?
- Has the deductible been met for this plan year?
- Is a referral or prior authorisation required?
Call 510-465-7982 and ask for billing, with your card to hand. Confirming in advance takes a few minutes and is far easier than resolving it afterwards.
What tends to vary
Where plans differ most
Often 12 to 30 per year
Many plans cap the number of chiropractic visits in a plan year, separately from other benefits.
Applies before the benefit does
If the deductible has not been met, you may be responsible for the full negotiated rate until it is.
Documentation matters
Plans generally require treatment to be documented as medically necessary, which is another reason the examination and notes matter.
At the clinic
The clinic
FAQ
Frequently asked questions
What if my plan is not accepted?
Then self-pay rates apply, and those are published. We tell you before treatment begins, not afterwards.
Do I need a referral?
Some plans require one, many do not. It is one of the things worth checking when you call your insurer.
Related
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