You have questions, we have answers. Insurance plans and their benefits are an endless moving target!
If you do not have insurance, or your coverage is inadequate, please ask about our affordable Time for Service fees. This may be a better alternative for you!
If you are being treated as part of a personal injury or auto accident case, it is imperative that you let us know when you schedule your first visit.
As with most providers, we do our best to keep up with the changing landscape of insurance. However, it is important to understand that the patient – not the insurance company – is ultimately responsible for any fees associated with treatment. Co-pays and deductibles are due when services are provided. It is the insurance company who decides what a patient is billed – not the provider.
For up-to-date information on what your plan covers, please contact your insurance provider. If you need assistance with this, we would be happy to help!
We Are a Participating Provider with the following Companies:
Aetna
Horizon Blue Cross / Blue Shield – please note we do not participate with NJ Family Care
Cigna PPO
Amerihealth
American Specialty Health Network (ASHN)
Medicare – please note we do not participate with United Healthcare Medicare Advantage Plans
Qualcare (But not Atlantic Health Qualcare)
For your convenience, we also bill to numerous plans on an Out of Network basis including:
Mail Handlers
Guardian
Atlantic Health Qualcare
United Healthcare PPO
Landmark
Oxford
Terms people often don’t know, but feel foolish asking (please don’t ever feel foolish about insurance questions!)
Deductible – The total amount you are personally responsible for before your insurance company starts paying benefits. Typically, deductibles are calculated as your total healthcare spending among all eligible services. Not all plans have a deductible, and among those that do the amount varies from a hundred to thousands of dollars.
Copay – For in network plans, the amount the patient pays per visit. The copay may or may not cover all of the patient’s obligation, depending on the plan.
Coinsurance – For plans that utilize this system, the insurance company determines (using their own formula) what the patient will pay for treatment. This amount is typically billed after the visit, as we don’t know what it is until after insurance processes the claim.
Patient Obligation – A fancy way of saying the amount the patient is to be billed for treatment. This is determined solely by the insurance company.
Limits – Many plans have limits on the number of chiropractic treatments that are covered per year. You can still continue treatment after this limit is reached, however the insurance company will not pay towards it.
A note about claim processing- Claims for treatment are sent out on a weekly basis, and responses from the insurance companies are most often timely. There are, however, exceptions to this which more commonly occur in physical medicine (chiropractic care, physical therapy, occupational therapy, etc) than with other health providers. In these cases, a delay may occur because the insurance company is forwarding all physical medicine claims to an outside specialist for evaluation.
Our Promise: When further information about your treatment is requested by your insurance, we send it in a timely manner. We do everything possible on our end to get a response ASAP. If you ever find that your insurance company is not responding, please feel free to call our office. If we cannot obtain a direct answer from your insurance, we can guide you with what steps you may be able to take to get answers from them.