Q - What is Rockenmacher Chiropractic's Financial Policy for people with health insurance?
A - If you are not familiar with your benefits, we are happy to verify you insurance coverage and go over it with you as a courtesy. However, it is not a guarantee of benefits and/or payment as your insurance policy is a contract between you and your insurance carrier, not between your insurance carrier and this office. We do not keep track of the benefit limitations of your health plan as your may have gone to another practitioner during the year. We are happy to bill insurance for you as a courtesy to you. But we do not take responsibility for knowing any patient’s eligibility, coverage or benefits. We are simply forwarding your claim to your insurance company on your behalf. Any amount left unpaid by any patient’s insurance is the sole responsibility of the patient.
In addition, our acceptance of your insurance card is not a statement to you to the effect that:
- we expect your insurance to cover the fees incurred by services you receive, or . . .
- we are willing to discount our fee if the amount covered by your insurance plan is less than you expected.
Q - What if I have an HMO or PPO Plan?
A - PPO plans:
Payments for services applied to your deductible, coinsurance or copay, and any non-covered services are expected at the time of service. If your insurance company processes the claim differently, a statement will be sent to you at which time the balance will be due. If we are unable to verify your insurance at the time of the initial visit, we will handle your case as if you are a cash patient until we are able to verify eligibility and benefits.
HMO (and select PPO) plans:
Dr. Rockenmacher is no longer accepting HMO plans and is an out of network provider of Anthem BlueCross PPO.
Dr. Abella-Desuyo accepts HMO and is an in-network provider of Anthem BlueCross PPO: Payments for coinsurance, copay, and/or any non-covered services are expected at the time of service. Often times, documentation from the patient is required for authorization, but authorization is not guaranteed as treatment is approved based on medical necessity. It is imperative that patients fill out the subjective complaint questionnaires during the course of treatment for continued care to show medical necessity. Should a patient refuse to fill out the required paperwork, payment will be due at the time of service and we will handle your account as a cash patient.
Q - What is my deductible?
A - Your deductible amount is the amount your insurance expects you to pay before they will begin paying for any treatment for each year. This deductible amount is set by your plan, and every plan is different. For your individual deductible amount, you will need to contact your insurance company. Please note that for many plans, it is not the full amount of the fee which is applied to your deductible -- only your insurance company's allowed amount is applied to your deductible.
Q - What is my co-pay?
A - Your co-pay is the amount you are responsible for that is set by your insurance plan.
Q - What are Non-Covered Services?
A - As the name implies, these are services which is not included in the services your insurance has agreed to pay a portion of. Being non-covered, any deductible or co-pay amount will not apply to the non-covered service(s), and the total cost of these service(s) is the patient's responsibility.
Q - What are some of these non-covered services?
A - Because coverage varies widely from plan to plan and insurance company to insurance company, only your insurance company would be able to give you a list of services which it will not cover. Rockenmacher Chiropractic does not routinely get a list of services which are covered or non-covered by a patient's insurance. Our doctors recommend treatment based on a patient's individual need, not his or her insurance coverage.
Q - What are Rockenmacher Chiropractic's billing procedures?
A - Our office sends out insurance claims weekly. To send in your claims, we will need a copy of your insurance card (if you haven't already provided it). Also, the doctors will indicate special codes telling your insurance company his/her diagnosis – the reason he/she's treating you. Once we receive your insurance card and these codes from the doctor, we can start billing. And once your insurance company receives your claim, they usually have a response to us within about three to four weeks.
Q - Will I receive monthly statements?
A - Each month you will receive a statement of all services and payments which took place over the previous 30 days if there is balance due. This statement will show the fees, payments received, and accounting adjustments. If you have any questions on any of your statements, please feel free to call our Office Manager for clarification.
Q - Can I set up a payment plan?
A - In case of financial difficulty, a payment plan may be arranged in which the patient may pay for services over a period of time rather than paying at time of service or by each month's statement. Payment plans are then monitored to ensure that all agreements are being kept.