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Tuesday, March 21, 2017

Healthcare Fee Schedules



Our office continues to receive shocked and, on occasion, agitated feedback from prospective patients who call our office that are either under-insured or have a policy with a company we don’t participate with when we inform them of our cash rate fee schedule. These folks feel that our rate(s) for care are high or, on occasion, exorbitant and state that they will seek care elsewhere. The fact is that our fee schedule is simply something we have no control over.

For ANY healthcare provider that participates with insurance company reimbursement for services rendered they are required by federal law (i.e. Health Insurance Portability and Accountability Act) to adopt a cash rate fee schedule that is comparable to the reimbursement rates of the insurers they participate with. To do so otherwise (i.e. discount their fees for cash paying patients) is known as a “dual fee schedule”. This unfortunately is illegal and to do so would open any healthcare provider up to litigation from the insurance company(s) for insurance fraud.

The doctors at Life in Motion Chiropractic and Wellness are also everyday consumers and we would relish the opportunity to provide those individuals who are under-insured or possess policies we don’t participate with a discounted rate(s) for care but due to federal statutes our hands are tied. The only way we would legally be able to provide any discount is to simply stop our participation with health insurance companies and we entertained this idea at the end of 2016. The feedback we received from most of our current insured patients was not favorable and therefore we decided to maintain our involvement with third-party payers (i.e. BC/BS, UHC, UPMC).

In closing, we encourage everyone to petition their local government representatives with your thoughts about the healthcare conundrum in the United States and request that they begin to allow healthcare providers more latitude with their billing practices so that we can truly make healthcare affordable for everyone!

Here is the LINK to our current fee schedule.

NOTE: The one service that we do offer in our office that is not covered by health insurance and therefore allows us to set our own fee is myofascial therapy (i.e. massage). If you feel that your particular problem is related to muscular tension/pain our rates for strictly myofascial therapy is $1/minute with a 15 minute minimum however you can schedule appointments for up to one hour.

Here is the LINK for more information on this service.

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