Out-of-Network Insurance billable for Chiropractic care:
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Chiropractic Insurance In-Network vs. Out-of-Network
The difference between a Chiropractor who takes In-Network insurance and a Chiropractor who is Out-of-Network.
There is reimbursement for your care in both options.
An In-Network Chiropractor accepts a fee structure the insurance company has negotiated for a particular treatment / procedure code. In-Network doctors sign a contract with an insurance company and adhere to the negotiated reimbursable fee schedule. The reimbursement rate is a fee agreed to and accepted by the Chiropractor for each “covered” in-office procedure. The benefits of being an In-Network provider is being listed in the insurance company directory, as a result, hope for the chiropractor in being visible to more potential patients.
Being out-of-network means that the Chiropractor is not limited in their scope of chiropractic techniques “covered”. Certain techniques in-network are not in the reimbursable fee schedule. As a result, the Chiropractor is confined to using with patients only those techniques they know they will get paid for, and not what’s best for the patient.
An Out-of-Network Chiropractor does not participate in the reimbursable fee structure dictated by the insurance company and has slightly more leeway in treatment options.
In-network chiropractors bill insurance companies directly and get reimbursed directly on your behalf. Our office being out-of-network, we provide for you a superbill invoice that you yourself will submit to your insurance company directly and get reimbursed back directly.
In Dr. Kaminsky’s opinion, the out-of-network advantages for the patient is care from a practitioner who is not treating a volume of patients, but rather able to offer more quality time to each patient. In Dr. Kaminsky’s practice, this means each patient receives more hands-on time of chiropractic care and with techniques most suitable for the patient that deliver the quickest results.
There is also more time to take continuing education seminars, more time to read and more time to continue learning. The reason for this is simple. Out of network Chiropractors like Dr. Kaminsky do not spend time filling out forms, reports and authorization requests for the insurance company in order to get approval for care. This practice is very burdensome and time consuming, something in-network chiropractors must do for every in-network patient they accept for care.
Dr. Kaminsky spends his time learning new techniques, researching and attending seminars as there is no need to spend countless hours on paperwork appeasing insurance company personnel who read cases all day long and often deny care based on trivial criteria. The insurance company employee may or may not even be a chiropractor. Besides not knowing the patient, not examining the patient and having no interaction with the patient; however making a decision to allow or deny treatment based on notes.
Being an out-of-network chiropractor allows Dr. Kaminsky to recommend treatment based on merit and implement techniques most appropriate for each patient, without rushing.
Dr. Kaminsky’s intention for each patient is always the best possible treatment outcome and quality of care possible, in the least amount of visits.
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