ALTON CHIROPRACTIC NEUROLOGY
OFFICE POLICY/FINANCIAL POLICY
We believe that a clear definition of our office policies will allow both, you, the patient, and us, the doctor to concentrate on the big issue-REGAINING AND MAINTAINING YOUR HEALTH.
OFFICE POLICY:
If you are unable to keep an appointment for any reason, we require that you call immediately to reschedule your visit. IF YOU FAIL TO NOTIFY US THAT YOU WILL NOT BE KEEPING YOUR SCHEDULED APPOINTMENT, A MISSED APPOINTMENT FEE MAY BE CHARGED, at our discretion. We attempt to honor all appointments at the scheduled time. If you are late, you may have to wait for the next available appointment.
FINANCIAL POLICY:
ALL PATIENTS ARE RESPONSIBLE TO PAY 100% OF THEIR BILL AS SERVICES ARE RENDERED. IF CARE IS EXTENSIVE AND CAUSES A TRUE FINANCIAL HARDSHIP, A PAYMENT AGREEMENT CAN BE SIGNED WHICH WILL SPELL OUT A MONTHLY PAYMENT AMOUNT.
General Insurance/Group Health Insurance: To all patients that seek reimbursement of services by insurance. Insurance has failed to keep pace with the reasonable charges for chiropractic care. Due to this fact, this office will bill for services, but will not be writing off the agreed upon charges dictated by the insurance companies. This is formal notification that insurance will only cover a portion of your visits. If you have questions regarding this policy please speak with the doctor.
Children: Children, as well as adults benefit from chiropractic care. In an effort to make this more affordable for the parents, we have initiated a special policy for children. All children will be treated for $25.00 per adjustment. This fee structure will apply until the child is sixteen (16) years of age, at which time they will be considered an adult. This special price applies to chiropractic adjustments only. It does not apply to examinations.
Public Aid (YouthCare only): If you are on public assistance, this type of coverage only covers children up to the age of 2l years of age. We will bill the state agency for your chiropractic adjustments. Chiropractic adjustments are the only covered service in this office. If you require a "non-covered" service, you are responsible to pay I 00% at the time the service is performed. You will be informed at the time of services as to the necessity and cost of each "noncovered" service. We are out of network with Molina and Meridian and therefore not covered.
Medicare: This office is a non-participating provider for Medicare. Medicare will reimburse this office for chiropractic adjustments only. The number of covered visits may be limited by diagnosis and severity of condition. Medicare requires me to notify you in advance that your chiropractic treatment may not be covered and that you will be required to pay this if Medicare denies reimbursement to this office. If you require a "non-covered" service, you will be responsible to pay at the time of service. Payment will be expected for all services denied by Medicare.
Workers Compensation: All patients covered by Illinois Workers Compensation are required to file an accident report with their employer. It is your responsibility to provide all necessary billing information to this office within five (5) working days of your initial visit. Failure to do so will make you a cash patient and payment in full will be required on day five (5). If you have retained an attorney, you are further required to provide this office with all attorney information and to sign a lien protecting the doctors' outstanding bill at the time of settlement. ALL workers compensation patients are required to make a minimal monthly payment of$20.00 until the case is settled. This payment is required even if you are no longer under active care, no exceptions. If you are a Missouri Workers Compensation patient, you are required by the laws in your state to get your employers approval to come to this office. Without this, the Missouri Workers Compensation will not pay for your care.