INSURANCE INFORMATION

Insurance

We accept and are providers for Medicare Part B, Sanford, Avera, Blue Cross & Blue Shield, Cigna and Midlands Choice. However, it is best to check with your insurance company to determine if you have chiropractic coverage and if we are a provider before your appointment.

If your insurance covers chiropractic, but we are not listed as a provider, let us know and we can provide a form for you to send to your insurance. Your insurance company will either send you a check or apply the charges to your annual deductible.

Medicare Part B

In regards to chiropractic, Medicare Part B, does not pay for everything. According to the Medicare website, Medicare Part B only covers manipulation of the spine if medically necessary to correct a subluxation when provided by a chiropractor or other qualified provider.

Medicare may not cover the cost if they feel the service is too frequent, if it does not relate to the spine, and is determined to be maintenance care. Other items not covered are listed on our Medical Necessity Form.

Medicare Advantage/Part C Plans

We are not in-network with ANY Medicare Advantage/Part C plans. In the past, we have submitted claims on behalf of patients with these plans, accepting their fee schedules and documentation rules even though we were out-of-network.

Effective October 1, 2024, we will no longer be able to submit claims to Medicare Advantage/Part C plans. Due to staffing and reimbursement constraints, continuing this service is not feasible. However, we are happy to provide you with a “superbill.” If your plan offers out-of-network benefits, you can submit this superbill to your insurance plan for potential reimbursement, though this will be between you and your insurance provider.

Please note that when you visit our clinic, you will be considered a self-pay patient. Since Medicare Advantage follows most Medicare rules, we are not allowed to charge you more than the Medicare-approved rate.

Accident and Workman’s Comp Insurance

*Important Policy Change for New Accident and New Workers’ Comp Patients Effective April 1, 2023

-New Accident Patients will be required to pay out of pocket the day of the appointment for all services provided.  The patient will be responsible for submitting what they paid to the accident insurance for reimbursement.

-We will no longer treat Workers’ Compensation patients.