Insurance

Health Insurance and Chiropractic Care

Most insurance policies do offer some limited type coverage of chiropractic care. However, if yours does not we encourage you to urge your employer or health insurance broker to change your policy to one that does. Your freedom to choose your own health care provider is a fundamental right. If we can help in any way please let us know.

Private HMO - Preferred Provider Network

The Institute of Pain Management does offer a preferred patient type of insurance for those without health insurance. Some of today's insurance policies do not provide the type of coverage that you may desire and larger patient payment will be required. If this is a hardship, ask you doctor about the Preferred Provider Network Private HMO. For a one time fee of $50.00 will allow you to get the health restoring help you need and pay for care at your own pace.

Help with Insurance Filing

It is important that you understand that health and accident insurance policies are an arrangement between an insurance carrier and you, the patient, their insured. Of course, the Institute of Pain Management will prepare any necessary reports and forms to assist you in making collection from your insurance company. Furthermore, any amount authorized to be paid directly to the Institute of Pain Management will be credited to your account upon receipt.

Insurance Procedures

However, you must clearly understand and agree that all services rendered to you are charged directly to you and that you are personally responsible for payment. In order to facilitate the correct and rapid processing of your insurance claim, we suggest you do the following:

1 Call your insurance agent to determine exactly what coverage you have. Ask what deductible, if any, applies to your policy. Then ask how much of your claim your insurance company will pay.
2 Obtain insurance claim forms, if needed, from your agent or insurance company, fill in the required personal information and bring them to our office. Be sure to write down all information concerning any injury (auto, work related, slipping, etc.)
3 When you bring your insurance forms to our office, please bring all of your insurance cards so we may check the benefits. Ask one of our staff to double check them. This will help avoid any unnecessary errors and give you a chance to ask any questions that you may have regarding your claim. Our staff is experienced in handling insurance claims and will be glad to help in any way we can.
4 If your policy has a deductible feature, then we suggest you pay this amount at the outset of your care. We also require that you keep your account current on at least a weekly basis.
5 Any reimbursement from payments received from your insurance company will promptly be credited to your account.
6 If you are an auto accident or on the job injury victim, we suggest you discuss your coverage with our insurance office. We may well have suggestions that will help you in this regard.
7 You will be asked to authorize the Institute of Pain Management to furnish information regarding your case directly to your insurance company and to assign all benefits and all collections efforts from your carrier as a result of the claim. This will expedite its handling.
8 Release of billing information: What to expect from the insurance company. Each insurance company may have some slight variance within reason of Usual, Reasonable and Customary charges as to what the normal standard of charges should be in Corpus Christi. It has been our experience any specific carrier may by default make a determination, weighing heavily in favor of the carrier of not paying for all of your reasonable medically documented medical charges that should otherwise be covered. We reserve the right to answer any bills reviewed by the carrier and insist that you bring any unfavorable review to or immediate attention so that we may respond on your behalf.

On accounts with outstanding unpaid balances, it is our policy to retain a check for outstanding balances before releasing any bills. This check will be held until you have resolved your settlement with the insurance carrier.

If during the course of your care you decide you want copies of your medical bills, you must first:

1 Pay your bill in full or leave a check for the outstanding balance.
2 Must obtain a valid and signed Assignment of Benefits signed by your carrier which guarantees direct payment for the outstanding balance on your account directly to our office.

We will than be more than happy to provide you with a full itemized bill and complete medical documentation.

Ultimately we can not be responsible for the outcome of your negotiation efforts with any insurance company as it applies to your outstanding balance. We suggest that if you encounter unreasonable difficulties with the carrier that you report that adjustor to the State Board of Insurance in Austin. We will assist you with making a formal complaint. You also may want to retain professional advisement by your own personal legal council. If you do not know an attorney you can call the Local Start Bar of Texas at 884-1809 for a recommendation or we can make several recommendations should you request.

Your questions about any aspect of your care or account are invited. Please feel free to ask your doctor or any available staff member. We will make every effort to answer your inquiries.