Understanding the true cost of care can be difficult. Active Spine and Joint Center works hard to make this easier by providing accurate and personal estimates of your out-of-pocket costs whether you are insured or not. We believe everyone should have access to high quality healthcare and understand available benefits, discounts and/or limitations that may be applicable to you.
There are many different insurance providers and hundreds of different plans for each provider which may end up with significantly different out-of-pocket costs from one patient to the next. One reason is that different plans may choose to use a deductible or use a copay for services rendered. Another reason is that some plans may have certain limitations on the number of treatments or dollar limit the plan will pay for. In any circumstance using health insurance for care will also stipulate that your care must be medically necessary as defined by your insurance provider.
The definition of medical necessity can vary based on the insurance provider, but most generally can be summarized by:
Care that is necessary to return the patient to their pre-injury status. This must have a measurable active injury with a treatment plan in place to resolve the injury which can be re-measured to determine clinical effectiveness or maximum medical improvement.
Active Spine and Joint Center aims to provide a higher level of care and return you not to just the same as you were before injury, but stronger and more resilient than ever. Our team works hard to uncover the root cause of your injury, correct it and strengthen surrounding areas to help prevent re-injury or remove compensation barriers that keep you from your normal daily activities.
In certain cases, or patients with certain performance goals from care (athletes, wellness care, adjustments “because it feels good”) the framework to define care as medically necessary does not exist. Because of this, we offer wellness care and performance care appointments. In either scenario, we require a thorough functional assessment to help us determine if you are a candidate for that level of care.
Keep in mind that an estimate is just that – an estimate. It is not a guarantee of the exact amount you will be responsible for paying. Your care will be based on your specific needs and outcome goals. If the services you need change during your treatment, your out-of-pockets costs may change, too. Our team works hard to provide you accurate, updated information should we see a change in your treatment needs.
We are also limited to the information we receive by your insurance provider – sometimes we are given inaccurate benefits or there may be certain qualifying procedures that are not shared. You can help take charge by making sure to review your insurance plan benefit summary. If you cannot locate your benefit summary, there is typically a patient customer service phone number located on the bottom or the back of your card that you can call to ask about your chiropractic benefits.
Our team is always happy to help you make the most of your care – give us a call or click here to schedule your next appointment with us.