Patient Information

INSURANCE INFORMATION

The dynamic of health insurance has changed drastically over the last several years.  Guidelines are becoming more and more strict regarding what is covered and what is not.  We are required to justify medical necessity for all treatment that is billed to insurance based on the chiropractic guidelines set forth by the individual insurance companies. In order for treatment to be billed to insurance as medically necessary, the treatment must meet certain criteria.  You must be under an active treatment plan with quantifiable, attainable goals for a certain number of treatments.  Re-exams or Outcome Assessments must be performed no more than every 30 days to continue care that is filed with insurance to show continual improvement. Although recommended for maintaining spinal health, the following are NOT considered medically necessary treatment for billing to insurance:

• Supportive care which is long-term treatment for patients who have reached maximum therapeutic benefit but progressively deteriorate when there are periodic trials of treatment withdrawal.
• Preventative/Maintenance care which is care that is typically long-term, but not necessary to treat a specific medical condition. Rather it is treatment that would prevent symptomatic deterioration or to promote health and prevent future problems.

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In addition, there are some therapies and treatments that the doctors recommend in certain cases that may not be covered by an individual policy and can not be billed.  These vary from policy to policy, but may include any or all of the following:

• Graston Technique®
• Kinesio taping
• Decompression therapy
• Laser Therapy
• Radial Pulse Wave therapy (RPW)
• Intersegmental traction (Rollerbed)
• Vibrational cervical traction
• Ultrasound therapy
• Dry hydrotherapy (Waterbed)
• Extremity adjustments (that are not directly associated to a diagnosed spinal condition)

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If all or some of your treatment is not expected to be paid by insurance, then you will be asked to pay for that treatment/service out of pocket. The good news is, we have a cash discount program through Patient Options that you can enroll in at no cost to significantly minimize your out of pocket costs.

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We have copies of the chiropractic billing guidelines for the most common insurance available in our office.  If you have any questions, are not sure what category of treatment you fall into or need to schedule an exam, please contact our office at (502) 231-4003.

Patient-Doctor Agreements

The purpose of these agreements is to allow us to more completely serve you and to get the best results in the shortest amount of time. It is our experience that those who adhere to these get the best results.  These things help our office run much more effectively and efficiently. These policies allow the doctor and staff to allocate the necessary time to each patient.

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Arrival and Check-In

When you arrive, please check in at the front desk. You may be asked to use our self check-in computer or fill out necessary forms for that visit. If needed, our Patient Care Representative or Patient Liaison will be happy to assist you with this. Please adhere to your scheduled appointment time and contact us if you will be late. We will do our best to accommodate you if it is within a reasonable time of your appointment. Otherwise you will be asked to reschedule. Please take care of any payment required and scheduling of your next appointment prior to being seen by the doctor. Changes to future appointments can be scheduled after treatment in the rare instance that there was a change to your treatment plan or if it was not done upon arrival to the office.

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New Injuries

In the event you sustain a new injury/condition, please call our office to schedule an appointment.  You will need an exam or evaluation that will require an office visit before treatment.  This can not be done in the time we allot for a regular adjustment appointment as the documentation necessary is extensive.

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Workshop

It is important that all patients attend our Your Spine/Your Health Workshop. This workshop explains how the body functions, how chiropractic works and most importantly, how you can expedite the healing process. Family and friends are invited to attend. There is no charge for this workshop.

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Your Financial Arrangement

The doctor is here to focus on providing you with chiropractic care.  Therefore, any issues with the financial portion of your care should be discussed with our billing department.  If you find you cannot fulfill your financial obligation, please notify the billing department so that payment arrangements can be made.  Our policy is that patient accounts are paid timely.  Your insurance carrier is expected to pay their portion within 30 days of submission.  Our claims are submitted weekly.  If you do not receive an explanation of benefits from your insurance carrier within 45 days, you are responsible for contacting your carrier to attempt to get the claim paid.  If you should receive a check from your carrier, it should be brought to our office with the attached explanation of benefits.  There is a $25.00 return check fee for all checks returned for non-sufficient funds.  Should you have questions regarding billing issues, please contact our billing office Monday, Wednesday, or Thursday 9:00am – 5:00pm or Tuesday 9:00am – 1:00pm

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Treatment Plan

You are scheduled for a certain number of treatments in a set amount of time to get the best result we both desire. Should you have to change your appointment, we would like for you to reschedule at a different time in the same day. If this is not possible, try to schedule an additional appointment within one week to make up the one missed.  Progress evaluations, and/or Outcome Assessments will be performed every 30 days during acute treatment to rate your progress and future treatment.  This is also a requirement for billing of insurance in order to satisfy medical necessity requirements.  The goal in our office is to help everyone we see “Get Back to Life” (normal living and work activities) as soon as possible.  It is of the utmost importance that you adhere to the scheduled plan of treatment as closely as possible.  If you need to make a permanent change to your plan of treatment, we ask that you schedule an office visit with the doctor to discuss the changes.  These changes may affect whether treatment is covered by insurance, as they may not continue to cover services when the patient does not comply to the doctor’s prescription of care.  The Patient Liaison, Patient Care Representative, or Chiropractic Assistant is not authorized to make changes to your care plan.

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Absence / Excuse Notes

Off work/school slips are given from appointment to appointment.  If you are taken off work/school for a period of time, you must adhere to your prescribed treatment. Our office can not back date an off work note prior to the date of your appointment in our office.

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Termination of services

Should you choose to discontinue services, any payment of outstanding balance is due within 30 days of your final statement.

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Upsets

We are here to serve you. Please speak with the doctor about anything that could be upsetting you (i.e. long waits, confusion about treatment, etc.). We want your visits at our office to be pleasant and with the best results possible. As you can see, all these things can help our office run much more effective. Following the above policies allows the doctor and staff to allocate the necessary time to each patient.

Patient Rights

1. The right to confidentiality of medical records. 2. The right to be treated with consideration and respect. 3. The right to be informed in an understandable language about their health condition. 4. The right to participate in decisions affecting their health. 5. The right to be informed of the appropriate or medically necessary treatment options available for their health condition. 6. The right to voice any questions, concerns or complaints about any aspect of their health coverage, care/services provided. 7. The right to be informed about our facility and health coverage as it relates to services provided by our facility. 8. The right to be informed of policies by which the patient is to abide. 9. The right to privacy and confidentiality while receiving care. 10. The rights to not accept care or to terminate service at own discretion.

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Patients have the following responsibilities:

1. The responsibility to supply accurate and complete medical history information. 2. The responsibility to advise staff if information is not understandable. 3. The responsibility to inform staff if the treatment plan does not meet the individual’s need or cannot be followed. 4. The responsibility to follow the agreed treatment plan. 5. The responsibility to contact provider when unable to keep appointments. 6. The responsibility for knowing the terms/benefit coverage for services provided and for fulfilling financial obligations as agreed.

Patient Rights