When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing. “This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an innetwork facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.
You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have these protections:
• You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
• Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit
If you think you’ve been wrongly billed, contact the HHS via the federal phone number for information and complaints: 1-800-985-3059.
Visit www.cms.gov/nosurprises/consum... for more information about your rights under federal law.
Costs of our Services
New Patient exam fee: $63-$120
Established Patient exam fee: $38-$79
Chiropractic adjustment: $32-$65
Manual Therapy/Muscle work: $22-$35
Self-Care Management Training: $27-35
Mechanical Traction: $15-25
Therapeutic Exercise: $37-50
Electrical Stimulation: $15-25
These prices indicate the fee for one unit of each individual code. The cost may vary between ranges depending on complexity of your condition, time spent, services received, and if payment same day discount applies. Each treatment involves a chiropractic adjustment and manual therapy. Exam fees are charged for new patients, established patients with new injuries or complaints, and established patients who have not been seen in over 90 days.
The total number of treatments is subject to each patient’s diagnosis or condition specifically and how the body responds to treatment.
Before seeing any of our chiropractors, if we are not in network with your insurance provider, or you opt not to use your insurance or if you do not have insurance, these costs will be explained to you, and per the "No Surprises Act" you will be asked to sign a paper stating that you agree to pay the cost of treatment as outlined above at the time of each visit.
Here, at Drummond Chiropractic, we aim to get the results you are looking for in as few visits as possible, with out any billing surprises.
To learn more about how we treat here at Drummond Chiropractic, CLICK HERE.
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Drummond Chiropractic, LLC
Best Chiropractors in Bloomington
565 N Walnut St
Bloomington, IN 47404
(812) 336 - 2423