Insurance

INTRODUCTION

It is important that you understand that health and accident insurance policies are an arrangement between an insurance carrier and you, the patient, the insured.  Of course, the Physical Synergy staff will prepare any necessary reports and forms to assist you in making a collection from the insurance company.  Furthermore, any amount authorized to be paid directly to Physical Synergy will be credited to your account upon receipt.

IMPORTANT INFORMATION 

There are many different types of policies and types of coverage.  It is a good idea to know your personal insurance coverage.  However, if you have any questions, feel free to ask us!  Out staff is experienced in insurance claim handling and will be glad to help in any way we can.

WORKER’S COMPENSATION

If you were hurt on the job, usually all services are covered completely by your employer’s Worker’s Compensation insurance.  You need to tell us the date of the accident and a brief description of the incident.  We will need to notify the insurance carrier of your injuries to obtain approval.  We will bill the insurance carrier directly.

AUTO ACCIDENTS/NO FAULT INSURANCE

If you were injured in an automobile accident, all charges will be submitted to your automobile insurance medpay policy or your regular family health insurance.  Please bring your automobile insurance card to our office so we may verify your coverage.  We will bill the responsible insurance company.  If an attorney is representing you, we will work directly with him or her regarding payment.

             ANTHEM BLUE CROSS BLUE SHIELD (BCBS)

Physical Synergy is considered out-of-network with BCBS.  Most treatment is covered if you have out-of-network benefits.  Most policies require a one time calendar year deductible (usually $100-500) and a co-insurance per visit ($10-$30).  Note:  Because we are out-of-network, BCBS will send payment directly to you.  We have decided on the following policy:  You, the patient, can pay us in full for your treatment per visit or endorse the BCBS checks you receive directly to our office and we will credit your account upon receipt.

HEALTHNET

Dr. Kristin Rayball is contracted with Healthnet.  Only chiropractic treatment is covered by Healthnet when Dr. Rayball is your doctor. Physical therapy/rehab is not covered. Most Healthnet policies require a co-payment per visit. Copays range from $5 to $45.  We request that you pay your copay upon each visit directly to the receptionist. Dr. Michael Troknya is not contracted with Healthnet. There may be out-of-network benefits that will require a calender year deductible and co-insurance per visit. We will verify the coverage for you.

CIGNA/UNITED HEALTHCARE/GOLDEN RULE/CONNECTICARE

  Physical Synergy is considered out-of-network with Cigna, United Healthcare, Golden Rule & Connecticare.  Most treatment is covered if you have out-of-network benefits.  Most policies require a calendar year deductible and a co-insurance per visit. We will be happy to call your insurance company for you to determine exactly what coverage you have.

MAJOR MEDICAL, UNION, ETC…

Most plans have a deductible and coinsurance.  We will be happy to call your insurance company for you to determine exactly what coverage you have.

MEDICARE

Medicare only pays for the adjustment (manipulation) given by the doctor.  It does not pay for x-rays, exams or therapy.  To make things affordable for our Medicare patients, we have decided on the following policy:

1. You are required to pay your deductible of $135.00 if not already paid to another doctor.  This covers the initial exam and therapy. 

2. For follow up visits, you are required to pay $10.00 for the therapy you receive.

MEDICAID/TITLE 19

Medicaid will no longer pay for your chiropractic care.

MISCELLANEOUS

Standard Process supplements, medical supplies, such as cervical collars, lumbar support belts, ice, etc. are not covered by insurance policies and will be charged to you directly.

WE PARTICIPATE IN THE FOLLOWING INSURANCE:

Healthnet

Medicare

Aetna

Oxford

Please call the office for more details.

*Some plans may require a deductible, please call the office directly for your exact benefits.