Network Provider for:
- Anthem Blue Cross/Blue Shield PPO
- United Healthcare
- Medicare
- Railroad Medicare
- Health Link
- Meritain Insurance
- Aetna
- Coventry GHP
- Golden Rule
- Aftra
Note: Personal Injury cases are billed to the liable party’s motor vehicle insurance carrier. See our PI policy for more information.
Out of Network for:
- Blue Cross/Blue Shield HMO and POS Plans
- Fiserv Health
- FMH
- Assurant
- MO Medicaid
- Cigna
- Humana Choice Care
- Ambetter
- ASH
Most networks require a deductible to be met before they will reimburse for treatment given by an out-of-network provider. Some networks do not cover any treatment given by an out-of-network provider. Please contact our office manager with your insurance information if you would like assistance determining your out-of-network chiropractic coverage.
INSURANCE TERMS
Understanding your policy – a glossary of common terms
- Copayment – A set dollar amount that is due for a doctors visit, emergency care, prescription, etc.
- OV – Office Visit copay or coinsurance amount for a doctors visit (usually a general practitioner)
- SOV/Specialist – Copay or coinsurance amount for a visit to a specialist (any practitioner with a narrowed field of practice)
Chiropractic care may fall under either of these categories, depending on how your insurance carrier views chiropractic care.
- Coinsurance – A percentage amount that is due for a doctors visit, emergency care, prescription, etc.
- Deductible – A set dollar amount for patient out-of-pocket expenses. Some insurance carriers pay 0% on claims until the annual deductible is met. Other carriers may charge a copay or coinsurance until the deductible is met, after which they pay 100% on claims.
Copays, coinsurance and deductibles vary by insurance carrier and group plan. More detailed information can be obtained by calling the customer service number on the back side of your insurance card.
INSURANCE FEES
It is the policy of this office to collect full copayment, coinsurance or payment in full at time of visit.
With Health Insurance
- Copay – Usually between $15 and $45 – check the front of your insurance card for your copay amount. If there is no amount listed then we will need to call your insurance company to determine the out-of-pocket amount per visit.
- Coinsurance – Usually between 10% and 50% – based off of the total billed amount for each visit. Depending on the treatment plan, coinsurance usually ranges from $5-40 per visit.
If your health plan has an annual deductible, you will usually have to meet that deductible (out-of-pocket) before your insurance company will begin paying on healthcare claims. If this is the case, visits will be billed at the cash rate of $45/visit until your deductible is met. Once your deductible is satisfied, standard copay or coinsurance rates apply.
Without Health Insurance
Please contact us to discuss payment options if you do not have health insurance.
Mistretta Chiropractic 