chiropractic insurance coverageI keep everything as clear and simple as possible.

When you come in for your first visit, the paperwork I ask you to fill out is as simple and short as I can make it while still obtaining a thorough health history. There are several places where we need your signature to indicate you understand what your treatment is all about, our privacy policy, and that my professional liability policy requires arbitration rather than a lawsuit to make things right if something bad happens.

If you have insurance that covers chiropractic, I am probably a preferred provider for your plan.

I’m one of only two in-network chiropractors in Poulsbo on the Kaiser (formerly Group Health) panel. I participate with Regence*, Premera, Lifewise, most United Healthcare plans*, union insurances, GEHA and many others. If you have a question about whether I am in-network with your particular insurance, please call.

While you are meeting your deductible, you will pay for your care at the time of service at our discounted cash rate. After your deductible is met you will be responsible for paying your copay at each visit.

I am unable to determine ahead of time exactly when your deductible is met and the exact terms of your insurance policy. I bill at the end of the month, and a couple of weeks later we get an Explanation of Benefits from your insurance company, which is the definitive word on how your policy works. If you have overpaid, I will refund the overpayment or carry it forward to use on future visits. If you have underpaid I’ll ask for the difference at your next visit.

*Special Regence, CIGNA and United Healthcare note:

Some Regence, CIGNA and United Healthcare programs currently require notification/preapproval for chiropractic care. This requires me to go online and enter a bunch of information in order for your care to be approved (or denied). This applies whether or not you are entitled by your policy to a certain number of visits per year, and if care is denied, I am unable to charge you or your insurance for the visit. This takes far too much of my time to be economically viable, so I will not be able to participate in plans that require this preauthorization. I will still be happy to see you, but you will have to pay our cash rate at the time of service. Please note that this does not currently apply to Federal or State of Washington Regence plans.

** ADDED NOTE ** The Washington Legislature has passed and the Governor has signed legislation that outlaws preauthorization requirements for the first six chiropractic visits. This legislation went into effect on July 1 2018, but as of early January, we have had no notification that these companies have changed their requirements. There are bills in the upcoming legislative session to clarify and strengthen the Legislature’s intent in passing this bill last session. If you have any political savvy, please support them and their sponsor, Sen. Rolfes.

Here’s how I handle Medicare.

You pay for your care at the time of service at my discounted Senior rate. I then bill Medicare (and any secondary insurance) for you. In a matter of weeks, if you have met your deductible, Medicare will send money to you directly to reimburse you for your care. There will be an exam charge at your first visit. Medicare requires the exam, but does not pay for it.

If you have a PIP claim you will have no out of pocket expense.

Motor vehicle accident care is covered by the Personal Injury Protection (PIP) portion of your automobile insurance policy with no copay. If you do not have such coverage, or if your PIP coverage is exhausted, I may continue to treat you without expense to you if you have an attorney who will agree to reimburse your care through the case settlement. In the event that no settlement is reached, you will be responsible for any remaining charges.

Labor & Industries claims are handled at no expense to you.

You will need to have an open L&I claim, or open one when you first come to the office. If the claim is denied or closed, you will be responsible for unpaid charges.

If you do not have insurance that covers chiropractic, payment is expected at time of service.

I do offer a discounted rate on the examination and subsequent adjustments. I also offer a military discount, since Tricare does not cover chiropractic care.

I do not accept Medicaid/Apple Care patients, except on a cash basis. These programs do not cover chiropractic care.

I do not extend credit.

I do my best to keep the cost of care reasonable, and part of that is not billing patients. If you are in a hardship situation and need care, I will work with you to come up with a periodic payment that you can manage, but I will expect that payment to be made regularly and without reminding until your balance is zero.

Laser therapy is NOT covered by insurance.

If I determine that laser therapy may be beneficial for you, I will do one treatment gratis to see how you respond. If you respond well, I will determine the appropriate number of visits to correct your condition. A typical protocol for a chronic condition would be ten visits. I offer a discount for purchasing the entire protocol at the beginning of treatment.

Why I don’t post prices online.

We’re not allowed to do it. Many factors come into play in determining your exact out-of-pocket cost per visit, including your deductible, your copay, whether your insurance covers chiropractic at all, and whether I am a participating provider for your plan. Insurance companies do not like me interpreting their plans for them. If you want a close estimate of what your insurance covers and what you will owe, it’s best to call your insurance company directly. If you don’t have insurance and would like to know what discounts might apply and what your costs will be, call me.