How many people have an unsettling feeling of “how much is this going to cost? “ when visiting a healthcare provider? For most, insurance is a love-hate relationship. We are relieved when insurance covers our medical expenses, and find it a complete headache when they don’t.
Ideally, patients should be focused on their health. That is why at TAI Chiropractic NYC we make sure our patients know all of our fees upfront prior to starting treatment. As part of our clinic trying to help patients eliminate financial worry, here are some of the basics when it comes to insurance.
Terminology
Individual Deductible: The yearly dollar amount you, the patient, would pay BEFORE your insurance covers part/all of your medical costs.
Co-insurance: The percentage of your medical bill the patient would be responsible for.
Out of pocket maximum: The maximum dollar amount you, as a patient, would pay for your medical bills. After this amount has been met, insurance companies generally will cover 100% of your medical costs.
Visit Limit: Some insurance plans will have visit limits for specialists per calendar year/per policy year.
Prior-Authorization: Some insurance carriers require prior approval before treatment starts. Don’t worry, our team will take care of this for you, so you don’t have to.
Insurance Billing Time Frame
Although we process your insurance right away, sometimes things do not go as planned. Generally, we ask patients to wait 3 months for the first response. Even if the insurance company stated they would cover your medical expenses, sometimes they still deny the service. If the claim/service is denied, our team will do our best to appeal the claim as many times as necessary. Unfortunately, this process may take up to 1 year or so. We will do our very best so there are no surprises.
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