FAQ's Patients With Insurance
*SLO Wellness Center is considered a non-participating provider of HMO and PPO insurance plans*
Q: What does it mean that SLO Wellness is a “non-participating” provider of HMO and PPO insurances plans?
A: For PPO plans our doctors are still providers for your insurance! However, we have opted to be “out of network” with insurance because of the limitations they put on doctors in providing optimal care.
For HMO plans there are no “out of network” benefits. Our doctors do however offer very affordable discounted rates and payment plans that are tailored to fit most budgets. Please refer to our Patients With No Insurance FAQ’S.
Q: What is the difference between an “in network” provider and an “out of network” provider?
A: An “in network” provider is a doctor who offers care under the limitations and discretion of an insurance company. Often times benefits for “in network” providers are less expensive for the insurer, but do not allow doctors to provide you a full beneficial treatment tailored to your health related goals. Because insurance does not deem many of the therapeutic benefits of chiropractic care as “medically necessary”, insurance potentially can limit our doctor’s care and in turn the patient’s health goals.
An “out of network” provider is a doctor who offers Patient Centered Care without the influence and limitations of an insurance company. Many insurance plans offer “out of network” benefits for subscribers. Your insurance will be able to answer any out of network benefits questions for you regarding chiropractic care. Often times out of network benefits are the same as “in network” benefits for patients. To find out if your insurance is consider "in network" or "out of network" please check our in and out of network page.
Q: What is my deductible?
A: A deductible is any amount of money that your insurance expects you to pay out of pocket before they will begin paying for any treatment. A deductible is set by your specific insurance company for your specific plan, and every plan is different. Please note that often times the full amount of the service fee is NOT applied to your deductible. Your insurance is responsible for regulating the allowed amount to be applied. Please contact your insurance company to see how much your deductible is and how much of your service treatment will be applied to the deductible.
Q: What is my co-pay?
A: Since SLO Wellness Center is considered “out of network” with PPO and HMO plans, insurance does not offer a set co-pay amount for our services.
Q: What are Non-Covered Services?
A: These are chiropractic services that your insurance has designated as “not medically necessary”. Therefore charges for these procedures will NOT be applied to your deductible and the total cost of these services is the patient’s responsibility. Because coverage varies widely depending on the insurance company and plan specifics, we encourage you to contact your insurance company directly in order to obtain a list of “Non-Covered Services”.
Q: How much does an initial visit and returning visit cost?
A: Our initial visit involves a comprehensive evaluation of you neuromuscular system to assist our doctors in understanding your body and make proper recommendations for your health goals. The initial visit is $130.
Our returning visits are based on the treatment recommendations discussed by you and your doctor on your initial evaluation. Returning visit’s normally cost $55. Package plans and reduced rates are available depending on your specific treatment plan.
Q: How are payments taken?
A: SLO Wellness Center expects payment upfront for services rendered. As a courtesy to you, we offer to bill your insurance at no extra charge. Depending on your plan specifics your insurance will then reimburse a percentage back to you. A normal insurance reimbursement is anywhere from $9.00 - $25.00 depending on your deductible and medical necessity. In order to know how much to expect back from your insurance in reimbursement, please contact them and ask about your “out of network chiropractic care benefits.”
At a convenience to you we accept all major credit cards including Visa, MasterCard, and Discover, as well as cash and check.
SLO Wellness Center also offers affordable discounted rates and payments plans that are designed to fit most budgets. Please see our rates of service page.
Q: Can I get billed for my treatment?
A: SLO Wellness Center’s policy is to take payment upfront at time of service.
Q: How is chiropractic care billed to my insurance?
A: Our billing department sends out insurance claims once a week. On those claims our doctors indicate special ICD codes that tell your insurance company the reason for your visit (diagnosis), and what treatment is being done (charges). Once your insurance receives your claims it usually takes three to four weeks for reimbursement.