So, you’ve decided you need chiropractic care. You schedule an appointment with a nearby practice, check to be sure they accept your insurance plan, and head to your first appointment… But a few weeks later, you’re surprised to receive a bill in the mail. What happened? Didn’t your insurance provider cover the visit? You even checked first!
This situation might be due to a practice called “balance billing”, and the fact that it’s illegal doesn’t appear to be stopping it completely. Some practitioners are still making this mistake, even though it violates their agreement with your insurance company.
If a medical practice is in-network with an insurance company and the patient has those covered benefits, then it is illegal for the medical practice to bill for any difference between the charged amount for the service and the pre-negotiated reimbursement rate paid by the insurance company.
For example, let’s assume your chiropractor normally charges $100 for a particular service or treatment. After accepting a payment of $50 from your insurance company, he sends you a bill for the remaining $50 balance. Many patients have paid these types of bills, unaware that they should have contested them, but balance billing is actually illegal. Most importantly, you shouldn’t have to pay this bill.
When you call to schedule an appointment with a chiropractor, ask if they accept your insurance plan’s payment and inquire whether you will owe any extra. A copayment is common, but balance billing should not be.
At Green Chiropractic we do not engage in balance billing, and strive to keep our fee structure simple and transparent for our patients. Just ask, and we’ll help you understand our fees and insurance policies.