Chiropractor and as your chiropractor in Franklin, TN we really want our patients understand the costs of healthcare and what’s your insurance covers and what they don’t deductibles coinsurance says. These are questions we get all the time because people really understand how insurance works and in the end we probably won’t either unless we deal with it all the time. So in general health insurance is not going to cover maintenance care it will cover care for when you’re hurting or in pain. Unfortunately this is a short sighted oversight by the insurance companies because they would save themselves ton of money if they would pay for maintenance care because maintenance care keeps you from getting hurt especially in a chiropractic office. So first of all just know that maintenance care is something that’s generally not covered for general health care plans around Hajer area and chiropractor Franklinton would be BlueCross Cigna Aetna United Health Care Medicare Golden Rule private healthcare insurance and some other smaller ones. Well that being said they all have different plans. Insurance Deductible coinsurance what they allow per visit really insurances of C of I don’t knows and mateys when it comes to insurance the first thing we do at is to verify what your Chiropractor In Franklin,TN insurance benefits are. So we look to see where your deductible is now you don’t know don’t know what deductible is generally something that you have to pay out of your pocket before they will cover anything which is again a little bit asinine because we’re already paying a monthly premium which is over the last several years gone up with our benefits going down.
While he touted touted that everyone has healthcare which is probably great but most of you who now have health care really don’t have any coverage anymore. Ten years ago when chiropractor in Franklin, TN was seeing patients benefits were much better you’d get more visits. He’d have a lower deductible to be less out-of-pocket expenses for people. But now that has definitely changed. So if verify insurance is worktable these days are generally at least 2000 or more we typically see 4000 or 5000 not up to even 10000 or deductibles which basically is just disaster insurance which is good to have in mind the chiropractor in Franklin, TN opinion because I mean you want to have some sort of insurance in course in case something happens. But in regards to just regular care that you would receive in our office or medical rotters office or what have you. It’s not going to cover you for anything. All right. So that’s the first thing we do. So again the deductible is the patient responsibility. And there’s no benefits until that deductible has been paid to the provider. The next thing we check is if the patient has a coinsurance or a copay. People also get confused about the coinsurance and a copay a copay is a set amount of money you’d spend per visit. So for example if you have a 25 dollar copay generally with this there’s only a few plans that have this right now and that’s going to be your federal Blue Cross plans. But generally this is not necessarily a deductible attached to these plans. So for example if you get 20 visits a year you pay twenty dollars per visit.
For those 20 that are allowed through your insurance company. Now if you have a coinsurance that’s sure it’s attached to a deductible. So most people have anywhere from 18 20 coinsurance to a 50 50 coinsurance. So what that means is a huge coinsurance would mean the deductible has been met the insurance will pay 80 percent of the allowed amount and the patient would pay 20 percent of the allowed them out. So for easy math let’s just say the charges were a hundred bucks under allowed the insurance company would pay the provider 80 dollars and the patient would be responsible for the other 20 dollars and that’s how coinsurance works is generally not that simple math. For example if a provider puts in 200 dollars worth of charges generally that’s cut down to the allowable amount once you say it’s a hundred and fifty five dollars. And that 80 percent would be paid through the insurance and the 20 percent would be paid for the patient. But that’s how coinsurance works. And again generally attached deductible plans and Chiropractor In Franklin,TN these days deductibles are higher. So even if there’s an 80 20 coinsurance still probably not going to have a lot of benefits. And tell that was one method. Another addition to the deductibles and coinsurance conversation would be out of pocket Maxes. Generally there is an out-of-pocket max attached to each policy which means that’s the most someone is going to spend out of their pocket in any given calendar year.
So for example if you have a 5000 dollar deductible on a seven thousand dollar out-of-pocket max what that means is you’ll pay no more than seven thousand dollars out of your pocket for care for that year. Now that does not include things like your your premiums your monthly. You got to pay for those every month or if you don’t pay for those at all all benefits are null and void. They’ll stop your coverage 100 percent. The next it discusses how many visits you are allowed per year. Now this is again different per policy. We’ve seen no chiropractic care covered up to unlimited coverage. We’re not a medical necessity. It’s all individual to your policy. So that is something you have to look at. Generally a rule of thumb and not really a rule of thumb I should say a Chiropractor In Franklin,TN. says usually around 20 minutes a year has a pretty average visit maximum year for chiropractic. Now the other side of that is sometimes there are dollar taxes attached to it so if you’re allowed a thousand dollars a year for chiropractic care what that means is that’s what the insurance company will pay directly to the provider. So that would be money after health insurance etc. So that would be another a Chiropractor In Franklin,TN way to look at visits per year. Next your Chiropractor In Franklin,TN wants to go over you know medical necessity and what’s covered and what’s not. Insurance companies really play the game of medical necessity to their advantage. You know there’s a lot of things that are really actually necessary that they claim not medically necessary. There’s very long guidebooks and rules you have to follow. Chiropractors is essentially a game you know how to play it to get coverage and that’s not even provide us either.
That’s what the patients the the medical insurance companies are in it for profit. Always remember that and if they can get to covering something and paying for something they will do it every time. So it’s really important that as a patient as a consumer you are when you purchase your plan you really read the fine print because that’s where they insert a lot of things that you won’t know and won’t even really matter unless something comes up Chiropractor In Franklin,TN and you needed to use your insurance. The insurance companies rely on that people not take the time to understand what’s in their plan because you ever really need your insurance until you need it when you need it. They’re not there for you. That’s when things really get ugly and you get upset about that. So in general the other question I get from people your chiropractor and Franklinton is what’s covered what’s not covered as far as procedures. So in general and a chiropractor’s office there’s a few codes that are covered that would be 9 8 9 4 0 9 8 9 4 1 9 8 9 4 2 9 8 9 4 3 of those the adjustment codes as just how many levels you’re adjusting what areas you’re adjusting then 9 7 0 1 2 putschists mechanical traction 9 7 0 1 4 which is electrical muscle stem. 9 7 1 1 0 therapeutic exercises and 9 7 1 4 0 which is manual therapy. Also the exam Code 9 9 2 0 2 2 0 3 2 0 4 and Rigzin codes 9 9 2 1 2 2 and 3 and 2 and 4 are generally covered as well.
Other than that there’s not a whole lot of other codes that are covered in any chiropractor’s office included in your car. Chiropractor In Franklin,TN yet. So there’s a lot of non covered services that are really helpful such as decompression therapy and laser therapy. We utilize that a lot in our Chiropractor In Franklin,TN office Health Office chiropractic. And it really gets phenomenal results I really don’t know why they don’t cover stuff like that. It seems really asinine and silly to me because it gives patients better as a ton of literature support its validity. But of course like we talked about earlier insurance companies don’t want to pay they do everyday do whatever they can to not cover claims and that’s just how it works. And that’s not only a chiropractor’s office and medical facilities as well. There’s a lot of people frustrated with healthcare these days and not only consumers providers as well because in the end the only person this whole thing is benefiting right now is the insurance companies because the providers are getting paid last to Chiropractor In Franklin,TN to get the best care. the patients are paying more in premiums and getting less coverage. So premiums have gone up coverage has gone down due to higher deductibles. Yeah great more people have insurance but does it really matter when everyone’s paying more for healthcare these days. It really is becoming a really nasty circle of non coverage and this has happened over the last five years since Obamacare has come in. So I want you to understand how insurance works. Chiropractor In Franklin,TN office holders chiropractic works hard to give you as much benefits and coverage as possible.
Unfortunately we can only play by the rules set forth by the insurance companies and a lot of times those rules are stacked against both the providers and the patients and that’s just how it works these days. Maybe one day it’ll change back to a better program for both providers and patients. But a Chiropractor In Franklin,TN highly doubts that because they already have us we’re where we are now I don’t think they’ll ever go back to providing more coverage. You can find us at Seaboard Lane in Franklin Tennessee.