Important Changes Regarding Third Party Reimbursement For Chiropractic Care In 2018
Thank you for taking the time to read about the important changes at the health offices at Riverview Chiropractic Health. We have a cooperative arrangement in our offices that differs from many businesses. All of the Chiropractors and Massage therapists that use Riverview Chiropractic Health as an office own their individual practice. Riverview Chiropractic Health, PC manages the space, employees, equipment and operations for those practices. As such, cooperatively, each practice has decided that in 2018 all fees for chiropractic services will increase by $5. (The last time we increased our fees was in 2004). As you must know, the cost of providing services has increased over the years, and in order to continue to offer the great Chiropractic care that we offer as a team, we have to adjust our fees accordingly.
Accepting third party reimbursement, or insurance payment,for chiropractic services rendered has become increasingly complicated each year with the ever changing healthcare industry and rules. As a result, there will be some major changes in 2018 of which we would like you to be informed. Dr. William B. Davis, our founder, is no longer accepting third party reimbursement for Chiropractic services. He has terminated his agreements with Independent Health, Blue Cross, Blue Shield etc. As such, if you are going to receive chiropractic care from his practice, payment for services rendered are expected at the time of service.
As for Dr. Rowswell, Dr. Marinaccio, Dr. Tomko and Dr. Jeremiah Davis, each practice will continue to accept third party reimbursement for COVERED Chiropractic service. However, we have been made aware that covered Chiropractic services vary greatly per individual contract. It would be best if our patients were informed about the type of provisions they have for Chiropractic care. For instance, some companies do NOT reimburse for a Chiropractic examination, a Chiropractic re-examination, nutritional counsel, exercise instruction, review of external imaging or labs, records requests or even maintenance Chiropractic care. Many of you have been experiencing seemingly endless and repetitive questionnaires to audit our care plans and highlight whether your Chiropractic service is covered or not. This makes it extremely complicated as many of the same companies require these services to be performed, but will not reimburse for them. It also poses prospective problems for scheduling enough time to accomplish desired goals set by the providers for your health. Even though we have individual practices, we as providers all unanimously agree that we will NOT let insurance companies dictate the quality or quantity of care needed to help you achieve optimal health.
As Chiropractors, we all desire that our patients would be relieved of ill health, gain strength and ability to perform daily activities, be educated on prevention of future dis-ease, as well as get regular Chiropractic maintenance adjustments to pursue optimal health. However, that goal has been picked apart by the healthcare industry to be defined corporately. For instance, if the insurance company has purchased your Medicare plan and is administering Chiropractic benefits for a patient who is over 65, there are different rules than for someone who has the exact same insurance company, but is under 65. There are higher copays assigned to the patient than the 20% like Medicare Part B. Examinations and re-examinations are required monthly to determine if the care is active or maintenance that are expected to be paid for by the patient. Maintenance Chiropractic care is uncovered for the patient over 65. There are many more examples from various contracts, but in essence the Chiropractic benefits from third party payers are diminishing.
The team of Chiropractors here is committed to your goals for health. So, we have designed Chiropractic Maintenance Plansthat are available for you to purchase. These plans are designed specifically to meet the needs of our patients to maintain optimal health. But, we wanted to let you know about them early enough that you could purchase them on FSA plans if available. Maintenance Chiropractic care is the adjustment received when either you aren’t experiencing symptoms, or you have reached a level of care that your symptoms are not regressing. These visits do not require examinations, or decision making re-examinations to determine your frequency of care. You simply come in and get adjusted. These visits take approximately 5 minutes. Each doctor will have a highly desired hour each week available just for this type of Chiropractic care. It may be before or after commute, at peak evening or weekend hours. If you are scheduling a maintenance visit, you can come at any time your provider is available, and are given preferential scheduling, so please alert the front desk so we can plan accordingly.
This is an extremely difficult and complicated situation. It was not the desire of your provider to place restrictions on your ability to pursue optimal health. As providers, we also understand that health care benefits are costly, and you desire to maximize your benefits as you pursue optimal health. Understanding whether your carrier allows for maintenance Chiropractic care, provides for examinations, re-examinations, how many visits are allowable per year, knowing what your deductible is and what time of year that deductible starts again, and what type of Chiropractic care is reimbursed (etc.) will help you to know how to maximize that benefit. It may save you substantially by getting to a maintenance Chiropractic care level and planning your FSA accordingly.
On your next Chiropractic appointment, please discuss 2018 with your provider. It might be a good time of year to create your health goals and pursue optimal health naturally with Chiropractic.