Mailbag: A Pair of Questions about Maintenance Care and Insurance

Doc, Is Chiropractic Maintenance Care Covered Under My Insurance “Well-Care” Benefit?

No.  Well-visits are your annual physical where your MD will check your height, weight, blood pressure, breathing, eyes, ears, etc.  They may do more depending on the office and requirements of different states, but those are the basics.  Chiropractic maintenance (or wellness) care is the detection and correction of subluxation on an ongoing (weekly) basis for the purpose of keeping the nerve system free and clear, functioning at or as close to 100% as possible as often as possible.  This allow the body to work as optimal as possible and aids the bodily processes preventing disease, illness, and/or infirmity.

Doc, my friend, in your office had their insurance company pay them back for their maintenance care, can I do that also?

Yes, but no promises.  I’ve heard of this plenty of times and in each scenario here are the common factors.  1.  The person or family paid their membership up front.  2.  They received a statement from us indicating their payment, and number of adjustments received for that given month with proper coding of a maintenance visit.  3.  They mailed in the receipt to their insurance company on their own.  4.  They received payment at the discretion of their insurance company and according to their benefit plan.  5.  The person or family receiving the care was happy with what ever they received, regardless of the amount.

A couple of items to note here.  It is our experience that as a business who services customers, insurance companies are happy to reimburse their customers as opposed to paying providers like us.  You are their customer, they want you to stay with them, so they’ll service you better than they will us.  Secondly, it doesn’t happen 100% of the time.  Without hard numbers, it’s tough to say how much folks are actually receiving back.  We also have had it where folks have received nothing at all, as we prepared them for.  As we tell our kids at dinner, “you get what you get and you don’t get upset.”

If you would like to attempt this let us know and we’ll print a receipt/statement at the end of the month for you.  It’s that simple.