What does my insurance plan cover?
• That is a great Question! I HIGHLY recommend that you contact your insurance company personally to have them explain your specific benefits to you before your first appointment.
• While I can access certain information from your plan online, I can’t always see the fine details for each service. Each person’s plan is like a snowflake, unique and intricate like you and your plan.
• I can never guarantee coverage. All I can do is bill out to the insurance company and await their response.
How much will my appointments cost?
• Cost for services will always depend on your individual insurance plan
• Each person’s deductible, copay, coinsurance, etc. is different depending on the elections you made during your enrollment period for your insurance plan. Remember the snowflakes we just talked about? I am happy to try and look up this information for you, but again, it’s always best to verify this information with your insurance company directly. Disclaimer: We can never guarantee coverage or payment by the insurance company.
What's a deductible?
• A specified amount of money that the insured patient must pay before an insurance company will pay a claim.
For example: If your plan specifies that you have a $500 deductible, you would be responsible to fully pay for any medical costs up to $500 before your insurance company will pay towards a claim.
• Deductibles reset once a year; Typically, on January 1st. However, some companies have different plan years. i.e. Benefits for employees run from April 1st – March 31st each year.
What's a coinsurance?
• Some plans will include a coinsurance % after a deductible has been met. This means that once you have satisfied your deductible, you may still be responsible for a small percentage of your medical bills.
• For example: If your coinsurance is 10% and a claim is approved for $169.00, you are responsible for $16.90, while the insurance company would pay $152.10.
I was involved in a car accident. Can I use my auto insurance to pay for my treatment?
• Medical bills associated with car accident injuries can be paid using your auto insurance policy only if your plan includes Personal Injury Protection (PIP).
• You can contact your claims adjuster or auto insurance carrier to verify your PIP amount for the accident towards medical costs.
• Read more on this helpful Personal Injury blog by Adler and Giersch, a local Personal Injury Attorney and client advocate. https://www.adlergiersch.com/resources/blog/
What if I don’t have PIP coverage? Or what if the accident isn’t my fault?
• If you do not have PIP coverage, you will need to utilize your private health insurance for treatment. You would still be responsible for any balances not covered by your health insurance policy.
• If you were involved in an accident where you are not at fault and you wish to use the At-Fault parties’ PIP coverage to pay for your medical expenses, this is classified as a 3rd Party auto accident case.
• I hold the right to accept third party cases on a case by case basis. Third party cases sometimes take years to reconcile. I am a solo provider that offers quality one-on-one care. For this, I have a maximum number of third party cases I can accept at a given time. I would require that you sign a medical lien against your settlement to ensure payment once your case has been settled. Please call my office to inquire if I am currently accepting new third party cases.
Which services can I use my HSA or FSA?
• HSAs are for healthcare services that are billed to your insurance and medically necessary, regardless of network status with your insurance company.
• They cannot be used for maintenance or routine care.
• FSAs are a bit more flexible and can be used for wellness massages (maintenance and routine care), as long as you have documentation from your medical provider or chiropractor showing the number of visits recommended, frequency, an expiration date, and why the massage is needed (diagnosis or diagnoses.)
• For all massages involving HSAs or FSAs, your card on file will be charged at your appointment and your insurance company will directly reimburse you what you are owed after they process your claim.
• HSAs and FSAs do not cover additional time over 60 minutes or enhancements/ add-ons, or retail. Those will be charged separately at the time of your service.
How can I look up my insurance benefits for massage?
• To look up your own benefits, call the number on the back of your card and ask to speak to a representative. Let them know you are wanting your out of network benefits for massage with a licensed massage therapist from Resurrection Bodyworks. Please call our office for tax ID information.