Insurance is weird, am I right?

We all know that using health insurance is a bit of a daunting process. Whether you are looking at a copay or coinsurance, deductible, out of pocket, limitations or if adjustments are even covered at all, it’s just a bit tedious. We just want to give a quick rundown of how WE handle the bear of using health insurance in OUR office.

First, we will always, always, ALWAYS, verify your benefits no matter if we are an in or out of network provider. The next step is figuring out if you owe a copay for each visit or if your policy is based on coinsurance. The difference: your copay is a set amount (ex. $25 per visit) that you pay each time you receive an amazing adjustment from Dr. Dawes. Coinsurance is the amount you would owe us AFTER your deductible has been met. For example: A patient hits his/her deductible for the year and has an 80% coinsurance. This means that the patient will only be paying 20% of our going rate at the time. So as of now, each of our adjustments cost $50. If a patient has hit their deductible and has an 80% coinsurance than the rate, they would be paying for an office visit would be $10.

The next confusing part is LIMITATIONS. Most insurance policies put a limitation on how many chiropractic visits you may have in a year. This does NOT mean that they cover that many visits, but rather you are only allowed to submit that number of visits towards your deductible or out of pocket. After the limit has been met, patients must switch to self-pay until the beginning of the next year.

If a patient reaches their out-of-pocket amount for the year that means that each chiropractic visit (if it meets the limit criteria) is covered at 100% until the policy resets, which is typically December 31st.

Whether you want to use insurance or do self-pay, we are here to help you figure out which will benefit your lifestyle the most. At Stones River Chiropractic, our goal is to support you while finding your healthiest self, but sometimes the confusion of insurance can get in the way. We are here to assist and help you navigate, allowing you to reap the benefits of the BEST chiropractic care!