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How Adkore Handles Uninsured or partially insured patients

Healthcare has changed dramatically over the last few years; many major medical policies are becoming more limited over time and premiums appear to be increasing. With this increase, many people have decided to go uninsured and opt to self-pay for services on an as needed basis. A lot of facilities have employed self-pay programs to be able to offer uninsured patients or limited insurance patients a discount on medical services. At Adkore, we have joined the ChiroHealth USA network to provide our services to uninsured or limited insurance patients.

What is ChiroHealth USA?

ChiroHealthUSA is a network that we’re a part of for patients who are uninsured or partially insured. The patient can join within minutes right in our office for $49.00 and it covers the patient and their household dependents they list for a year. Members receive a discount off our normal fees with a maximum fee of $89.00 per the initial exam which includes treatment and $55.00 per routine visit. The routine visits are limited to a ½ hour of treatment per day. Chiropractic, medical massage, physical therapy, and acupuncture are included in this program. Spinal decompression is only covered by auto insurance - no major medical insurance policies follows an exclusive fee schedule of $84.00 per ½ hour session as a part of a customizable decompression package.

Which Patients Benefit Most From This Self-Pay Program?

ChiroHealth USA is offered to:

  1. Uninsured or Cash-Paying Patients
  2. Patients who do not have insurance at all can receive all services per the discount program

  3. Medicare and Medicaid Patients (Chiropractic Coverage Only)
  4. Most Medicare and Medicaid policies only cover spinal manipulation under the chiropractic benefit of the plan and some cover physical therapy under the physical therapy benefit of the plan. These patients can take advantage of ChiroHealth USA for the non-covered services such as medical massage and acupuncture. It can be used in conjunction with the Medicare/Medicaid policy in order to receive a full service treatment plan with maximized therapeutic benefit.

  5. Patients with Limited Insurance Policies
  6. There are some policies such as some Blue Cross Blue Shield plans that do not cover acupuncture or physical therapy at Adkore as an in-network service provider. At Adkore, we honor the insurance company’s fee schedule if the plan has out-of-network benefits. However, there are times when the out-of-network patient responsibility costs more than our ChiroHealth USA fee schedule. In this case, it might be more cost effective for the patient to enroll in the discount program for these services.

  7. Patients with Maxed Out Policies
  8. Many insurance plans are capped at a certain number of visits per year, some more limited than others. If the doctor recommends or patient would like more visits than their insurance allows, ChiroHealth USA is an option to continue the care that is needed.

    Another scenario is that many insurance plans require prior authorization for visits. Often times, we come to a halt in treatment because the insurance authorization department denies continued care requested by the doctors or limits the visit amount and date range in which the patient can be seen. Just like any other disruption of treatment, this can delay the recovery process. Since ChiroHealth USA is not an insurance company, members are not subject to any form of prior authorization or visit limitation so they are free to receive treatments as needed.

  9. Decompression Patients
  10. Spinal decompression is not covered by major medical insurance. It is only covered in the event of an auto accident where a personal injury claim would be opened and extends medical coverage. Therefore, the majority of patients that want or need decompression would have to pay out of pocket. Being an advanced technology treatment that can prevent surgery, spinal decompression can be pricey. At Adkore, the ChiroHealth USA reduced fee for decompression is $84 per session in addition to pre and post treatments; a total package is customized to each patients needs and the total is much cheaper than the average local rate.

Our mission at Adkore is to service as many patients as possible by providing the resources they need to receive the most effective treatment. As you have read, ChiroHealth USA is a great option that fits the mold for uninsured and insured patients. If you would like more information or would like to enroll, please contact the front desk at either location.

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Posted in: Adkore News