FAQ

If you cannot find your question please feel free to submit it.

I: Self-pay

1: If a patient does not have insurance, and I'm giving them a discounted fee for paying out-of-pocket, should I always give them the Hardship Form to justify the discount?

Nold only be recommended to have the Hardship form if you are charging a. It wou patient below your regular Payment at Time of Service Discount (PTSD) rate.

2: Is there a minimum amount as to when chiropractors are required to deposit prepaid payments into a separate bank account?

No. The Board of Chiropractic Medicine currently says that any chiropractor receiving any amount prior to rendering the services 'shall maintain a separate bank account' (see Rule 64B2-14.001 at https://www.flrules.com)

3: If a patient has a Discount Plan, do I need to have them sign an Assignment of Benefits? The patient pays us a discounted rate.

No. If the money comes to you directly from the patient, and that company does not provide coverage to the patient, then there are no benefits to assign, and therefore no AOB is required.

II: Privatize Insurance

1: Even though I'm Out-of-Network, I receive payments at the reduced In-Newtork fee schedule. Am I allowed to charge patients the difference?

Yes. That is called Balance-billing, and it is only allowed when you have not signed a contract with the patient's insurance network.

III: Medicare

1: Do chiropractors have to register with Medicare?

No. You can opt in or out of the Medicare program.

2: If I am a Non-participating provider, do I have to accept Medicare reimbursement as full payment for my services?

No. As a Non-par, providers are allowed to charge the patient the difference between the ‘Non-par Limiting Charge’ and the amount paid by Medicare.

3: I am not a Medicare provider. Can I charge Medicare patients my regular fees or the limiting charge on their fee schedule?

Providers may charge patients their regular fees as long as the provider has opted-out of the Medicare program (meaning that the provider has not registered with Medicare)

4: I have many patients with both Medicare and BCBS or CIGNA, but some people say to bill Medicare first, others to bill the other insurance first. Which one is the primary?

It depends. Other than Medicaid (which is ALWAYS the payer of last resort) you must check with the private insurance carrier to find out whether their policy acts as a primary or secondary to Medicare. While you’re at it, ask them if the bills are forwarded to the Secondary insurance automatically (‘automatic crossover’) or if you should do it yourself.

5: Do patients have to sign the ABN at every visit?

No. You could have the patient sign a multiple visit ABN valid for up to one year of treatment (or less if the treatment plan changes). You only need it for the visits in which you will be providing a service that is USUALLY covered by Medicare, but due to a special circumstance you anticipate the claim will be denied. You must have the patient sign it before the services are provided.

6: Do we change in the CMS 1500 form our normal fee for massage therapy which is $60.00 to limiting charge of $25.04??

No. You should always bill your regular charges, but you cannot charge Medicare patients more than the limiting charge.

IV: Medicaid

1: Are chiropractors allowed to charge Medicaid patients for services?

Yes. Medicaid providers are allowed to charge patients for any services that Medicaid does not cover. For covered services, though, providers must accept Medicaid payments as full payment for such service.

2: Is there a deductible or copayment for a chiropractic visit?

There is no deductible, but a copayment of $1.00 per visit applies to patients over 21 years of age.

3: How many chiropractic visits per year does Medicaid cover?

24. For patients under 21 years of age, additional treament may be approved if requested (this process might take weeks to complete)

V: Motor Vehicle Accidents

1: I'm treating a daughter and a mother who were injured while riding in the daughter's car. The mother does not have a policy but lives with another one of her daughters, who does have insurance. Where should we send the paperwork and bills?

Call the carrier for the policy of daughter that she lives with and confirm the mother's eligibility. By law, if a patient does not have PIP coverage, the next source of benefits is a relative living in the same household.

• 

  Testing
  Your Staff

  It is good to ask questions and see if you get the responses you should get. We will give C.A.s a written exam on their knowledge necessary to deal with day-to-day situations.
  

  
  
• 

  Evaluating Your Office

  Let us spend some time in your office to make sure you are compliant with Florida Statutes and the Board of Chiropractic Medicine rules.
  

  
  
• 

  Staff
  Training

  Whether it is a new hire or an existing C.A. (and chiropractors themselves), we will come to your office and polish all your CA's skills by going over all the most relevant information for all types of files: requirements, coverage, billing and collections. All of these for both Regular Care or Personal Injury files.
  

  
  
• 

  Other A+
  Companies

  Whether you need to get supplies for your back-office or a great P.I. attorney, our database has only the best in their field, based on professionalism, reliability and high level of satisfaction from our clients and ourselves!