Billing Your Insurance Company for Your Care
Sylvan Chiropractic Clinic and Wellness Center offers patients the ability to utilize their health care insurance to pay for the cost of their office treatments. Not all plans include coverage for the various services the clinic offers, and we encourage you to contact your private or corporate insurance company to verify benefits and eligibility prior to your first visit. For those patients without insurance coverage or for those patients who do not elect to utilize their benefits at this time, our practitioners do offer time-of-service discounts on the cost of your treatment when payment is made in the office. Below you will find a list of some of the major insurance companies the clinic accepts. Be aware that your individual practitioner may or may not accept all of these insurances; please inquire about your coverage when you call. If you do not see your company listed, please contact our office so that we may be of assistance in researching your options.
- MODA (formerly known as ODS)
- Providence Health Plans
- Regence BlueCross BlueShield of Oregon
- United Healthcare
- Health Net of Oregon
- American Specialty Health Networks
- American Chiropractic Network / Optum Health
- Great West/CIGNA
- PacificSource Health Plans
- Uni-Care/American Income Life
Patient Insurance Liability Information
The contract of medical health insurance is between the patient and the insurance company. The sylvan Chiropractic Clinic and Wellness Center cannot accept full responsibility for determining benefits in advance of your treatment. Possession of a medical insurance member ID card is NOT a guarantee of coverage. As a courtesy, we call your insurance to get a “quote” of benefits, but it is the responsibility of the insured to verify eligibility for their own health care benefits. A quote is NOT a guarantee of payment from your insurance company. Payment is subject to the terms and conditions of your policy. It is not our claim; the insurance company is not required to pay the provider. The insurance company’s sole legal obligation is to pay the “benefit” to their member. Among other reasons, misquotes can be given, maximums can be met prior to being seen at our clinic, policies and coverage can change, certain services involved in your treatment plan may not be covered under your policy, and amounts billed may be above your insurance allowable.
Co-Pays and Deductibles
All co-pays, co-insurance and deductibles must be collected at the time of service. We are happy to provide the service of billing your insurance company on your behalf and will accept payment from them directly but any monies owed on your account are ultimately your responsibility per the financial agreement you signed. The clinic can not be responsible for disputing or appealing the way your insurance has processed payment on a claim. In the event we are not paid in full by your insurance company (less any contractual write-offs we are to take with insurances we are contracted with) you will be balanced billed any remaining charges after your insurance has addressed a claim and required to pay us directly and work out your difficulties with your insurance carrier.
Medicare Non-Covered Services
According to existing Medicare law, most of the services in our clinic are NON-COVERED and are the responsibility of the patient.
EXAMPLES OF NON-COVERED SERVICES
All Services Other than Chiropractic Adjustments:
- Office Visits- to evaluate and manage, re-evaluate, advise, or give counsel regarding your health.
- Physiotherapy- such as massage, electrical stimulation, neuromuscular re-education, etc.
- Laboratory, Supplies, Vitamins, etc.
Various Chiropractic Adjustments or Treatments:
- Non-spinal manipulation to the shoulder, arm, leg, etc.
- Maintenance Care for when your condition is stable and not making any more improvement
- Wellness Care for the promotion of your health and prevention of future ailment or injury
Claims billed to private insurance are due in full within sixty (60) days after your primary and or secondary insurance has been billed. Any Workers’ Compensation and/or motor vehicle claims that are denied by the insurance carrier will become due in full once our office receives an official denial of the claim.
Questions or concerns regarding these financial policies can be directed to the clinic at 503-297-4447.