MINIMUM CONTRIBUTION
For all BCBS patients, please do not accept becoming a patient, unless you agree and recognize that we can file later to receive the legitimate funds to which we are entitled for the specific procedures we performed. 

We will file only when and if the chiropractic deductible is met, unless you pay the full BCBS price for the services in advance on that service date.  We can file when we have received equivalent funds toward your deductible. We are an in-network Preferred Provider; we file this information with the understanding we will automatically file your claims whenever we can. 

If, for some reason, you do not want to use your BCBS insurance, please make this clear upfront before we accept you as a patient.  By giving us your card or identification number, we understand this as using your BCBS insurance throughout your care.

BCBS LIMITATIONS

We are allowed by BCBS to see you only for the specified limitation of visits on your contract.  This is the case whether it pays us or only pays toward your deductible instead.  Whenever we file for a visit, BCBS subtracts that visit from this limitation whether it pays out or not.  Most often, the members do not have enough visits to pay down their deductible by being seen by a chiropractor exclusively.
RESTRICTED SELF PAY

The patients given a Self Pay fee are restricted.  You can wait until patients drop off, discontinue their plan of care, or whenever space is available.  They are granted so you can be seen enough to get better; they are not meant for occasional patients, UNLESS RE-CONTINUING A NEW PLAN OF CARE.

As a Self Pay patient, if you have not been seen for one year, you will have a fee of $75.00 for your return visit, if spaces are available.  If last seen is longer than a year and half, we may start you again at an initial fee of $150.00.
 
$60 is our published cost for an average adjustment.  $150 is our cost for a NP examination and the initial adjustment.  We call this Basis Care Chiropractic.
BCBS PROCEDURES

All receipts for any services filed with BCBS are balanced to express BCBS's remittance.  Both of us receive the same remittance, so you always should know the dispensation.

BCBS determines the amount owed by the patient and any monies from the filed procedures toward a deductible and the coinsurance and/or copayment.  They also determine what the provider is to receive.  We do not!

We only file with an expectation and a signed agreement that either/or your carrier and you together must satisfy the full retail cost of the entire services filed.

No provider keeps more money than what is reconciled by the remittance.  Credits can occur only when you have made a "payment", MINIMUM CONTRIBUTION,  that exceeds a later to be determined coinsurance and/or co-payment balance. 

Balances are owed when insurance did not pay us, and "Patient Owes Amount" is greater than what you paid that day of service.  It's most always better to file knowing, as best we can, it will clear.

We always have to estimate coinsurance on the day of services. We have been estimating low, and accepting only this low amount as long as it's close.  For coinsurance we may have increase or decrease your payment if your balance strays to far.  However, in applying any credit, we look at the actual "Patient Owes Amount" to determine any credit or your outstanding balance to date. 


We don't want to get caught in the middle of any family dispute.  If a young adult (18-25 yo) is on their parent's insurance, the parents are going to want to know about the case or their intention to seek chiropractic care.  We would have to maintain privacy; we have decided not to get involved in the first place, unless they all sign off and agree to our terms at intake.  18-25 year olds vary greatly with some married, with different last names, handicapped, fully self-sufficient, living at home, going to school, and even with children themselves.
     HIGH DEDUCTIBLES AND HSA/HRA ACCOUNTS

Our experiences have not been good with an HSA.  It's paid by insurance monies.  We must file to collect.  If the contract actually states an initial amount and an ongoing balance, it is likely to pay out.  If it does not, it will not.  When we file a claim, it is as an "active" patient expecting to receive our fully entitled procedures.  If it clears, either we get paid or the huge deductible is paid down and you owe it.  We always bill insurance the same with all the requirements of "medical necessity."
Higher deductibles have led to these special saving/checking accounts to be used for this deductible; however, we do not receive funds on the day of service.  Often they are not forthcoming.  BCBS calls these HRS/HSA funds that "might be available." You must pay a minimum of $150/60 toward your total fee until the claim settles through your HSA/HRA.  When it pays out completely to us, it pays the BCBS fees and any coinsurance, so we will credit any contribution.

If you want us to use it, you must use these funds to pay for the full costs as expected by any (1) active claim from BCBS using the procedures performed. This cannot be (3) self pay or a (2) minimum contrition patient.

Few patients have used their HSA funds to the amount required to meet their large deductible after which their contract kicked in and the patient pays only the required coinsurance.  This can work well for those needing more care.  However, sometimes the deductibles cannot be reached by the HSA funds exclusively. Carefully weigh the pros and cons of high deductibles and any premium savings. Some patients ask us to not use their insurer, because they would rather self pay out of pocket for their chiropractic care.

You will rarely meet these higher deductibles using exclusively chiropractic services.  We cannot pay more toward your deductible than the services used, nor the reverse. 
. PRIMARY AND SECONDARY
If your BCBS insurance changes, please update with our office, as circumstances will change.  Any changes with regard to having a primary and secondary policy with BCBS can greatly influence having a claim settled to our mutual satisfaction.  Your primary policy must have its deductible satisfied before it will pay the provider.  Your secondary policy will not necessarily settle this claim automatically with BCBS.  

We will require that you pay minimum contribution fees toward this claim each visit until your secondary insurance processes your claim satisfactorily.  Once resolved, we will apply any credits.  This has been very frustrating, time consuming, and could represent a lot of money.  We attempt to file and bill only out of this small private office.  We must do so receiving funds as we see patients to meet operational costs.

It's okay to select a chiropractor depending upon your insurer.  Also it is reasonable to select their technique as to what you're looking for.  We cannot be all things to all people.  It is important to know what to expect and how much it will cost you.  We believe that most patients elect coming here because of Dr. Katherine's reputation and not because of costs.


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CHIROPRACTIC FEE

Self Pay Fee     Helping You Today       Office Procedure 2021

Patients have generally three financial arrangements.  (1)They are active today with  no chiropractic deductible or it has been met.  (2)You are paying toward your required deductible as you seek our help.  (3)You are Self Pay.

If your deductible with BCBS is not met today, insurance will not pay us for the claim until this amount has been met.  This can only be confirmed by the insurer on the Provider Access.  A chiropractic deductible may be separate from your major medical deductible; your contract states that your deductible must be met for us to receive a satisfactory chiropractic pay out.  If not, you are responsible for any unpaid portion of what we billed BCBS.

Ind Chiro Ded Rem___________________      Fam Chiro Ded Rem_____________________


MINIMUM CONTRIBUTION: You will unlikely meet a $500+ deductible with just services from a chiropractor.  We will file immediately if you pay for each procedure or if your deductible shows to have been met at a later date.  Otherwise, we can use only your out of pocket funds to pay toward your required deductible by visit.
SELF PAY: This status can be given patients as long as we have room to schedule them.  Self Pay cannot be used with any insurance.  Read the conditions governing Self Pay  if you want to be given this option. Self Pay requires an initial cost of $150.00 with each follow up visitation at $60.  If you require additional services the costs may be more, but this is always made clear before proceeding. 

We are seriously committed to helping all our patients; refusing x-rays is respected but we view this as a lack of commitment to getting better.  

Any past visitation may be filed to recuperate any funds to our mutual advantage where about you may recover the difference between what you paid and the actual coinsurance/copay, less any small contribution we may have made to your deductible.  Seldom are larger deductibles resolved; you must recognize we can file anytime but not to pay down a deductible without equal receipt of your out of pocket funds.  Also larger expenditures for medical services could lower your deductible allowing you the opportunity to use your chiropractic portion of your BCBS insurance and/or allow us to file past claims to our mutual advantage.  

Primarily, we are set up as an In-Network Blue Cross Blue Shield Preferred Provider.  We file E-Claims daily; we want to be able to use your BCBS insurance to our mutual advantage.

Opt 1______ 150/60 MINIMUM CONTRIBUTION for services to be paid toward a deductible

Opt 2______150/60 SELF PAY fees with no insurance. Elect to not use an insurer

Opt 3______150/100 estimated fees to be filed immediately with BCBS until Ded is met

Opt 4______ACTIVE BCBS.  Pay only an estimated coinsurance/copay    est $10-$50

Opt 5______Atlas Orthogonal Specify.  Identify yourself and read handout.  Fees increase

Opt 6______HSA/HRA will pay 100% of my BCBS coinsurance and all specific procedural BCBS fees.  It must state such on my contract and have a balance to pay the claim.  I must pay, however, the minimal contribution until the first remittance clears funds.  We will file once only to see if it clears, because they most often do not clear; if the claims do clear, we will continue to file and credit accordingly.  We are equally entitled to these funds as all your BCBS providers.  Self Pay fees are not offered to circumvent HSA accounts. When these funds have ended or with the combination of your providers claimed services, BCBS will hopefully activate your chiropractic coverage

We do not accept out-of-network Advantage, supplementary insurance, auto claims, patient's seeking disability, VA, workman's compensation and any liability claims.  If you do require, you may not be accepted or released. We expect to receive our full insurance fees from any settlement.  Active BCBS policies will most often cover these costs with the benefit of in-network lowered adjusted fees.

We can know the insurer's dispensation of any claim only after the remittance is sent to both parties.  We will be reviewing the status of your BCBS deductible throughout the year.

Our billing accounts are an ever-changing and an ongoing process, they cannot on demand be a reflection of funds with a final reconciled balance.  When closed or with a reasonable notice, these accounts can be balanced by our office manager.

65%-75% of all patients cannot use their insurance. 25% of these patients likely will meet their BCBS deductible. 30% are over 65 and are Self Pay.  Only 20% of all patients have no chiropractic deductible and can immediately use their insurance.
I UNDERSTAND AND ACCEPT

X_________________________________________________________DATE _______________

SELF PAY PATIENT OR SPOUSE/INSURED PATIENT


Effective 4/21/2021

We do not accept any new patient that is listed as a "child" on their parent's policy, regardless of age, unless they are accompanied by their parent(s) at your Initial Intake.  The young adult patient and their parent are also willing to sign together all intake forms and abide by certain requirements for our protection regarding finances and releases.


X____________________________________________________________DATE_________________

YOUNG ADULT "CHILD", 18YO THROUGH 25 YO