At Active Life Chiropractic and Rehab, we do things a little differently than many other chiropractic clinics in that we treat each patient as a unique individual and use the full power and range of the considerably large ‘tool box’ available to us in Oregon. We do a lot more than simply adjust the spine. We use manual therapy to relax tense/spasmed muscles, we teach exercises and stretches to help reduce pain in office and for you to do at home to prolong treatment benefits long after treatment is finished. There may be numerous other services provided during a treatment that are billed as separate and distinct services. That means that our billing is also often a little different than other clinics. Please read the following explanation of services and how they are billed to commercial insurances.

It is important that you as the patient and client of your insurance company understand how services are billed and processed based on your individual policy and coverage.

Billing insurance is not a cash pay service where there is a flat rate. There are different types of therapies (procedures) provided, each carrying their own government determined fee (see below).
Services performed depend on what each patient needs on the day services are provided and could change for each visit.
On AVERAGE, New patient Evaluation appointments are typically billed around $350-$450 (which includes 2-3 therapeutic procedures and an evaluation code). Average Follow ups are generally billed around $180-$230.
However; the “covered rate” differs for each insurance company. It is contractually lowered, which means they (your insurance) ultimately determine your deductible, % coinsurance, or $ copay “patient responsibility”. If you have not met your deductible, you can expect to owe between $230-$350 for the first visit. Your deductible is an annual amount that your insurance company expects you to meet and pay out of pocket before your copay or coinsurance is supplemented by your policy coverage.
Furthermore, chiropractic is covered as an independent service, aside from other therapies that can be provided on the same day. If you have a Chiropractic copay, this will usually only cover the adjustment codes (98940-98943) done on the day of service. Physical Therapy codes (97012, 97014, 97110, 97112, 97114, 97140, 97530, 97026) are covered under a different part of your policy. Evaluations (99202-99205, 99212-99215) can have their own copay and/or apply to deductibles. Again: It is important that you as the patient and your insurance company’s client understand how services are billed and processed based on your individual policy and coverage. We strongly encourage you to contact your insurance company directly to ask the following questions:
-Does my Policy cover Chiropractic Care? Physical Therapy?
-Do I have a co-pay or co-insurance for chiropractic services and/or Physical Therapy? If so, what is the co-pay amount or co-insurance percentage?
-How much is my deductible?
-Do I need to meet my deductible before co-pay or co-insurance take effect?
-Are there visit limits? If so, what are they?
-Will I need a referral or prior authorization for my chiropractic and/or Physical Therapy appointments?
-Is Active Life Chiropractic and Rehab, LLC a participating/preferred provider with my policy? If not, what is my out of network coverage?

Price breakdown: (according to gov’t sources)
Evaluation: 99202 – 99205 $160 – $510
(new patients- depends on severity of case)

Re-Evaluation: 99212 – 99214 $140 – $300
(new injury or changed plan of care required by the state licensing boards every 60 days)

Adjustment: 98940-98943 $64 – $90 (depends on areas adjusted)

Below are the most common Physical Therapy codes performed by chiropractors (This is not an all inclusive list)
Therapeutic
Exercises: 97110 $52

Therapeutic
Activities: 97530 $68

Manual
Therapy: 97140 $48

Any combination (the Eval is in addition) can be performed during your visit and billed.
If you wish to opt out of any of these services, please tell your provider.

If you have additional Questions about this information please contact our office by calling: 503-855-3375, texting: 503-495-4924 or emailing: Hello@activelifechirorehab.com.
 

Insurance Terminology:

A DEDUCTIBLE is the initial amount that you must pay before your insurance plan begins to pay for your bills. Typically, a deductible is a fixed dollar amount.

A CO-PAYMENT is a set amount paid for each visit to a provider. If you have a $25 Chiropractic co-payment, you must pay $50 for each visit and your insurance company will pay for the remaining balance on all covered services. Co-payments may vary depending on the location such as hospital, clinic, or Urgent Care. Co-payments are due on the day you receive services. If you have any questions regarding your benefits, please call your insurance company.

CO-INSURANCE is the percentage of the total cost of the health service that you must pay after meeting your deductible until you have reached your out-of-pocket maximum for a certain period of time. Co-insurance rates vary. After you meet your out-of-pocket maximum for that period of time, then most insurance plans will pay 100 percent of the allowed amount.
In some instances, you may be responsible for a co-payment, deductible, and co-insurance amount during the same visit. Please check with your health insurance plan if you have questions.

In-Network pertains to treatment from doctors, clinics, health centers, hospitals, medical practices and other providers with whom your plan has an agreement to provide care for its members. Usually, you will pay less out of your own pocket when you receive treatments.

Out-Of-Network pertains to treatment from doctors, clinics, health centers, hospitals, medical practices, and other providers that do not have an agreement with your insurance to provide care to its members. You typically will pay more out of your own pocket when you receive treatment from out-of-network providers.