Understanding insurance coverage is tricky.

Understanding insurance coverage is tricky.

 

“In-Network”, “Out of Network”, “Allowable”, “Write –off”….yada yada yada. The terminology alone is enough to cause a headache, and all you REALLY want to know is how much is it going to cost you to get rid of said a headache? This is the million dollar question. And, depending on your healthcare plan, it can feel like it cost you a million dollars.

In Network, doctors have entered into a contract with a health insurance company to provide services for members at pre-negotiated rates. An out of network physician has not agreed to the discounted rates. With that being said, please know that seeking out an in network doctor is not always the best choice for you to get the care that you need.

Let me explain.

See, an in-network doctor signs a contract. This contract states the amount that the doctor can charge, what services he/she can charge for, how many services he/she can charge for, what hoops he/she must jump thru to get said visits. Whether you want to admit it or not, these limitations CAN and DO affect the care that you are receiving.

For one, what do you think happens if the in-network doctor feels that there is a great therapy that would get rid of your headache’s but then he finds out that your in-network insurance doesn’t agree? Do you think you still get it? NO. Not in most cases anyway. Instead, the doc bows down to the insurance “powers that be” and does what they tell him that he can do. And while, yes, you’ve only had to pay the $40 copay each time, but do you recognize that you are in fact paying a much higher cost?

How does that work?

Meanwhile, the out of network doc, since there is no contract, is free to actually practice health care!!! Go figure!!! He / She is not obligated to bend to the rules that the health insurance or their management organization has put in place. So now, you actually get the care that you so desperately need.

And although you may initially have to pay more out of pocket, what patients don’t understand is that because there are no contracted rates, ALL or MOST of what you pay in is actually credited to your deductible / out of pocket amount. And when that deductible /out of pocket is met, guess what happens?…The insurance company starts paying for your claims…And guess who gets that money that is being paid? ….YOU… The patient!! SO, you not only get the care that you need and deserve, you just might get a little reimbursement back from the insurance company.

Corrective Chiropractic CHOOSES to remain OUT of network.

Not because we can’t get in because we don’t want to get in. As many of you already know, Corrective Chiropractic is not like a traditional chiropractic office. We do not simply treat symptoms. We treat the cause of the symptom, often found to be a structural abnormality with your spine.

Using specialized adjustments, therapeutic exercise and other modalities, Dr. Wickstrom and the Corrective Chiropractic team work together to bring your spine back to its normal positioning, which corrects the cause of the symptoms that you’re having. This fact means that sometimes an insurance company may not cover all of the services that the doctor may recommend. That doesn’t mean that you don’t need them though. And by using an out of network provider, you are able to receive a comprehensive care plan that is structured for CORRECTION of the CAUSE, not just the symptom care that insurance companies pay for.

 

 

 

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