Understanding your Blue Cross Blue Shield responsibilities through a chiropractic physician.

Once your intake forms are completed we will obtain estimates for your BCBS insurance plan.  We will submit your insurance claims on your behalf.

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Estimates are determined by your BCBS Insurance carrier and not by your provider, prior estimates are generalized by your carrier as we cannot anticipate specific treatment plans or diagnosis. 

By using your BCBS insurance benefit you are agreeing to fees and policies set by BCBS, not your provider.  BCBS may change these fees and policies without notice. 

Any overpayment will be returned via credit/debit return or for cash payment by check as soon as the insurance notifies this office of their payment determination. You are responsible for knowing your plan’s  specific coverage  details.   All co-pays, co-insurance and deductibles are due at the time of service.

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The majority of BCBS PPO Plans cover all services provided in this office.

There are a limited number of BCBS plans that do not cover all the services provided in this office by a chiropractic physician.  

It is your responsibility to understand your policy and its provisions for covered services.

 

You may want to verify this coverage by speaking with your BCBS carrier, you may reference the following codes (these are standard practice codes and may or may not be utilized for your care, your doctor will determine the appropriate codes based on care plans)

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First Visit Codes: 99203, 99304

Treatment Codes: 98941, 98943, 97110, 97530

Acupuncture Codes: 97810

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Some BCBS policies exclude TMJ and/or Ankyloglossia coverage as a benefit, even if you and your doctor agree treatment is important.

In order to verify this coverage you may need to ask your insurance if they cover TMJ treatment.

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This office may not be aware of your individual policy exclusions prior to treatment. If exclusions to care or diagnosis are part of your coverage plan you will be responsible for the non-covered services.