Health insurance does not always mean less overall cost for doctor visits and treatments.
We are participating providers in Medicare Part B plans.
We are a participating provider for the private EPO of Dallas Regional Medical Center, Dallas Medical Center, and Dallas Medical Physician Group.
We accept cash, card, check, and HSA/Flex cards.
We offer payment plans if necessary.
Family discounts are available.
Discounts for First Responders (fire, police, EMS) and Mesquite ISD employees are available.
Let’s talk about health insurance for a minute. I regularly get calls from prospective patients asking, “do you accept my insurance?” Frequently, I have to tell them, “no.” However, I know for a fact that many people don’t understand how their insurance actually works and when they hear that we don’t accept their insurance they automatically assume that it’s going to be more expensive than if they went to another clinic that did. This is usually not the case. While I can’t possibly cover every facet of health insurance with each and every carrier, I can give a basic overview of how it works.
When looking at your insurance, you should first understand if your plan is structured with a “deductible” or a “copay.” Most plans in this day and age are high deductibles (>$3000). There are, of course, some employers that still offer plans with a copay that ranges anywhere from $20-70 per visit.
If your plan is a deductible plan: you are paying the contracted rate FOR EACH SERVICE that the insurance carrier sets with the healthcare provider. So, if you go to a chiropractic clinic that “accepts” your insurance you will pay the contracted rate for the exam and each individual treatment that you may receive on that visit. Same thing on all follow-up visits. Each visit may also vary in cost depending on what service is rendered. This is how is what you can expect until you finally reach your deductible, at which point most plans will transition to a “co-insurance” phase where you would pay a percentage of what you were paying. If your particular plan is an 80%/20%, that means the insurance carrier would pay 80% of the total bill and you would be responsible for the remaining 20%. The unfortunate issue with this type of coverage is that a majority of people never hit their deductible. Unless you’ve had surgery, or other notable expensive procedures, you will likely not ever hit your yearly deductible from basic doctor’s visits alone.
If your plan is a copay plan: you are paying the set copay amount for every visit, which is nice because you’ll typically know what each and every visit is going to cost. One of the only things you’ll need to take into consideration is whether or not the provider you are trying to see is classified by your carrier as a regular provider or a specialist (the specialist carries a higher copay cost). For copay plans, (usually) once you have met the “out of pocket expense” (OOPE) limit you will no longer have to pay anything for your doctor’s visits. These OOPE limits are usually fairly high, like deductibles, and unless you have a major medical expense in the year you’ll likely never hit it.
Again, the above two points are grossly simplified, but adequately cover the basics. The question that remains is, “if you don’t accept my insurance, won’t it cost me more to go to your clinic?” The answer to that is usually, No.
If you find yourself in the above category #1, 90% of the time you will find that our clinic is more cost efficient. Since we are not contracted with any major medical carrier, we are able to set our rates reasonably and without restriction on which services are or are not allowed. We have a set fee range for each visit, so you’ll know exactly what to expect. Generally speaking, if you find yourself having to pay more than $90 on your first visit, or more than $60 on any follow-up visits at another clinic, then you should have read what I’ve written more carefully. However, in some cases more involved treatment becomes necessary and you may find that a few visits may be different in cost. At our office you can expect the first visit to be $90-120 and any follow up visits to be $50-90. We will always tell you before hand if any treatment total will be over $60. However, if you’re desperate to use your insurance, you’re more than welcome to pay more out of pocket at another clinic.
If you find yourself in the above category #2, it boils down to the quality of service you’re hoping to receive. Our visit charges, though capped and all inclusive, will undoubtedly be more expensive that your uncommon $20 or $30 copay. However, keep in mind that you get what you pay for. Our clinic prides itself on spending quality one-on-one time between patient and provider. This clinic is not one where you see the doctor for 2 minutes, get treated, and then are shown the door. You can expect to have thorough coordination and discussion with our provider, as well as quality and efficiency in your treatment without the rush. Just because I can get an oil change at a chain store for $20 doesn’t mean I trust them to take care of my car or adequately answer my questions. I would personally rather pay more for quality service that I can trust. Don’t get me wrong. There are plenty of excellent providers out there that may accept your copay. Just be honest with your expectations and know that we strive to be the best in all we do. After all, some of our patients are driving 25+ miles to get service at our clinic. We must be doing something right.
The one exception at our clinic is that we do accept and bill Medicare. We wish to adequately care for our elderly, so all patients of Medicare age (65+) with Medicare Part B as their primary insurance, we will accept and bill Medicare directly for you. We do not deal with secondary insurance. There are also a few things you should understand. Medicare requires a physical examination and periodic re-examinations, but they do not pay for it. They require that we do it, but you are responsible for the cost of those physical examinations. Medicare also only covers spinal manipulation. They do not cover extremity (shoulders, knees, hips, etc) adjustments, muscle work, or any physical rehab. If you wish to receive these services, as they may be recommended, you will be responsible for paying them directly. Our clinic, as repeatedly illustrated above, does pride itself in providing quality services for reasonable prices should you elect to received these additional services. Also, until your deductible has been met, you are responsible for our clinic’s regular visit fees. Once you meet your deductible, Medicare pays for 80% of the spinal manipulation charge and you are responsible for the remaining 20%. Several of our current Medicare patients are currently paying somewhere around $8 per visit, though charges will vary from case to case.
Well, that more or less sums up the basics. We are more than happy to speak with you over the phone and answer any questions you may have regarding insurance and fees with regards to service at our clinic. We strive to provide: Quality service, cost efficiency, and long lasting trust and relationships. Please let us know how we can help you.