Insurance FAQs

It is our office’s intent to be as fully transparent as possible. We don’t like surprises and we respect that you don’t either. We want you to know what to expect before you step into our office. If you are not aware of your plan’s coverage or just received new insurance, here are a few bits of info as we jump into the 2020 benefit year.

  • Insurance benefits must be verified before our office is able to provide ANY information about your plan’s coverage. This process can take up to 2 business days as wait times at the top of the year are painfully long.
  • If your issue is immediate, we are more than happy to treat you as a cash patient until your coverage has been confirmed.
  • Most (but not all) insurance benefits restart at the beginning of the calendar year, this means your deductible and your visit count reset.
  • Deductible and copay or coinsurance is specific to each individual’s plan.
  • If you have a deductible, individual or family, you are responsible for each date of service until your deductible has been met and coverage begins.
  • Your copay/coinsurance is the percentage you are responsible for at the time of service once the deductible has been met .
  • Your copay or coinsurance is collected on the date of your service.
  • If you have pending dates of service that have not yet processed on the date your insurance is verified by our office, and your plan shows that the deductible has not been met, we can discuss your options.
  • We accept cash/debit, credit, Venmo, Health Savings (HSA), and Flex (FSA) cards.
  • We are an Out of Network provider. This means we are not part of any HMO network (example, Kaiser Permanente) or In Network plans
  • PPO & POS Out of Network plans may provide coverage which will be determined upon verification of the plans allowances.
  • If your plan does not allow for Out of Network coverage, see below.
  • For HMO you will need to contact your plan provider or Primary Care Physician for a referral to a plan-approved provider.
  • For In Network only coverage, you will need to contact your insurance company to find an In Network provider or Primary Care Physician for authorization.
  • If we confirm your plan does offer Out of Network coverage but payments are made directly to you, there are two options.
  • First option, we bill the insurance. However, you will need to place a credit card on file, which we charge once the date has processed and the Explanation of Benefits has been received. Your EOB will contain a check which is yours to cash or deposit, we will simply bill the card on file.
  • Second option, Superbill. This is essentially a cash option, and you deal directly with your own plan provider. You are responsible for services rendered, which are collected on the date of service. We provide a Superbill to you, which in turn, you submit to your plan provider.

Click ‘Request An Appointment’ to submit your information now!

Request an Appointment

A quote of benefits and/or authorization does not guarantee payment. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the plan’s contract at time of service. Should your insurance provider deny your claim, you will then be responsible for any outstanding balance. Call our team of professionals at DTLA Chiropractic today with further questions or concerns!