Insurance and Billing Information
Outline below are the 3 most popular Insurances Companies that Glynn Chiropractic is in network with.
To ensure a seamless and efficient treatment process, we highly recommend that all patients thoroughly acquaint themselves with their insurance benefits before seeking treatment. Our comprehension of your insurance coverage is subject to limitations, owing to the complexities inherent in individual policies. Such intricacies may include, but are not limited to, whether your deductible has been met, the presence and specifics of co-payments (whether for office visits or specific treatments), and any limitations on the number of visits or the total dollar amount covered.
Our knowledge of your insurance plan is fundamentally dependent on the information you provide. By being proactive in understanding the specifics of your insurance benefits, you play a pivotal role in enhancing the overall coordination and effectiveness of your care.
At our clinic we provide expert medical services and facilitating the insurance billing process on your behalf. In order for us to be more efficient with our billing and coding for our operations, we have partnered with an external company specializing in billing and coding. However, please be advised that the acceptance of claims is ultimately determined by your insurance provider.
In the event of a claim denial, while we are prepared to investigate the matter, it is important to understand that if our submission has been accurately processed and your insurance policy does not cover the service, you will be responsible for the payment. We appreciate your understanding and cooperation in ensuring a smooth and effective billing process.
If you do not have insurance we do accept cash paying patients.
Billing Practice at Glynn Chiropractic - CPT Code 98941 and 98943: Our billing system is meticulously aligned with assessing and treating the body as a cohesive unit, with a particular emphasis on its kinetic function. To this end, Glynn Chiropractic consistently employs CPT codes 98941 (Chiropractic manipulative treatment; spinal, 3-4 regions) and 98943 (Extraspinal, any region) for all patient treatments. These codes are not selected arbitrarily; they reflect our comprehensive approach to patient care. By evaluating and addressing the entire body, we recognize that pain or dysfunction in one area can be a manifestation of broader kinetic imbalances. The utilization of these specific codes ensures our billing practices accurately represent our holistic methodology, focusing on the interconnected nature of the musculoskeletal system and its impact on overall health and function.
Therapeutic Procedures - CPT Code 97110: This is an essential component of our treatment repertoire, representing a range of therapeutic procedures. These procedures are not limited to in-office interventions but also encompass patient education on at-home therapies, demonstration of proper movement patterns, and techniques for body enhancement. Specifically, this code addresses therapies aimed at developing strength, endurance, range of motion, and flexibility. Our personalized approach ensures that each patient receives tailored guidance and exercises that align with their unique physical condition and rehabilitation objectives. Employing CPT 97110 reflects our commitment to comprehensive care, focusing on both immediate treatment and long-term strategies for improved kinetic function and overall health.
Re Exam - CPT Code 99212: This is for problem-focused issues when there's been a lapse of treatment for over 30 days or in cases of a new injury / new issue. This code is a minimal exam code used for routine follow-up visits where your condition is relatively straightforward and stable where by informing your insurance company about your current condition and readiness for continued treatment. It's typically used for follow-up visits where your health is stable or showing signs of improvement, ensuring that your ongoing care is accurately documented and covered.
New Patient - CPT code 99202: This is utilized for expanded problem-focused evaluations of new patients. This code indicates a detailed examination and history taking, going beyond a basic assessment. It's used when a patient's condition requires a more in-depth evaluation to understand their health needs fully. The use of 99202 helps ensure comprehensive care from the outset, providing a thorough understanding of the patient's condition for effective treatment planning.
Re exam and New Patient exam codes can very in severity pending on the severity of the persons issues. These are 99203 - 99213, 99204 - 99214
We can not stress enough that every insurer has different policies. even if you kePT your policy from the last year, there still maybe some changes on what they cover for this year.
BCBS (PPO)
Covers Initial Exam and Re - Exam charges.
Covers spinal and extremity adjustment.
Therapeutic Procedure 97110: They will cover up to 60 minutes of therapies in accordance with the doctors findings and diagnosis.
Any additional services rendered, that exceed these times, the patient will be billed.
Some BCBS policies only cover a total of $60 per visit. Other policies cover everything.
Some policies have a certain amounts of visits while others have unlimited.
United health
This is a very limited Insurance company towards chiropractic care. If you have this insurance company, they pay a total of $60 per day. Meaning your treatment plan will be formed around the doctors findings and diagnosis as well as what your insurance covers.
Covers Initial Exam and Re - Exam charges.
Covers spinal and extremity adjustment up to $60 per treatment.
Again your treatment plan will be formed around the doctors findings and your benefits, meaning if therapies and adjustments are needed we will expand your treatments throughout the course of the week, so that your insurance covers your needs.
Therapeutic Procedure 97110: They will cover up to $60 total.(If this is your therapy treatment for the day, your adjustment will scheduled for another day)
Any additional services rendered, that exceed these times, the patient will be billed.
Some policies have a certain amounts of visits while others have unlimited.
medicare
Medicare only covers 98941 which is only a spinal adjustment.
Medicare does not cover any pains to the arms, or legs
Medicare does not cover any exams but warrants an exam in order to be treated. These charges are the patient’s responsibility.