West Chiropractic Workers' Compensation Policy

Welcome to the financial policies section of the West Chiropractic website. If you have any questions regarding your care at our office, please feel free to speak with any office staff members or the doctor. We want you, the patient, to feel comfortable and confident with your treatment here, along with knowing that your health care is our first priority.

Payment arrangements
The first thing that you need to know is that your employer or your employer's insurance carrier, by law, is financially responsible for payment of all treatment charges which are a result of your industrial injury or condition. You are entitled to receive all necessary care and treatment which restores your health to a pre-injury status or to a permanent and stationary condition.

Notification of Employer
When you have suffered a work-related injury or illness, the law requires that you notify your employer immediately, no later than 30 days from knowledge of your injury.

Pre-existing Condition or Symptoms
If it has been determined, upon my evaluation, that you are currently experiencing symptoms or problems that are unrelated to your industrial injury, your employer's Workers' Compensation insurance carrier will not be responsible for treatment.

Your Responsibilities
This office specializes in the treatment of Workers' Compensation patients, so it is very important for you to follow our recommendations and to keep your scheduled appointments with this office in order to achieve maximum benefit to your condition.

Medicare Policy

Deductible
Medicare requires that you pay a yearly deductible of $100.00 towards your Part B medical expenses before they will begin paying for covered services. If you have already been treated by other doctors this year, you may apply those bills toward your deductible.

Medicare Coverage
After you have met your deductible, Medicare will reimburse 80% of the "allowable" treatment charges. The only "allowable" treatment charge by a chiropractor is "manual manipulation of the spine."

X-Rays
X-Rays may be needed or necessary, as to be determined by the doctor, for proper care and treatment.

Examinations
Medicare will not reimburse for examination charges, and therefore, payment must be made by you upon services rendered.

Physical Therapy, Supplements and Supports
The doctor may determine that certain physical therapy modalities or procedures, vitamin supplements or orthopedic supports may be necessary to assist in the treatment of your condition. Medicare will not reimburse for any of these services
.

Health Insurance / Group Insurance - P.P.O.
(Preferred Provider Organization)

Policies
Policies may range in patients yearly deductible.

Deductibles
Deductibles may range in patients yearly deductible and are the patient's responsibility.

Coverage
The doctor is contracted as a "Preferred Provider" which means that the patient is not responsible for any balance other than deductibles or non covered benefits (vitamins, supports, etc...)

X-Rays
Covered if determined medically necessary by doctor evaluation.

Examination and Physical Therapy
Covered by the doctor being a Preferred Provider and patient is not responsible for the balance.

Therapeutic Massage
May be covered or may not. The Insurance company will need to be contacted.

Supplies, Supports and Vitamins
Generally not covered. This may be the patient's responsibility.

Health Insurance / Group Insurance - P.O.S.
(Point of Service)

Policies
may range in patients yearly deductible and 10% of payment is required by the patient.

Deductible
Some insurance companies have yearly deductibles before the insurance plan pays the doctor's office for health care coverage. Payment can be made to the doctor's office until your deductible is met and our office will bill your health insurance as a courtesy, or you can bill it directly.

Coverage
Some insurance companies cover a percentage of an office visit and treatment session.

Example - 90% coverage means that the insurance will cover 90% of the cost leaving the patient responsible for the remaining 10% of the bill.

X-Rays
Some insurance companies cover x-rays if medically needed. We will need to contact your insurance company.

Examination and Physical Therapy
An exam is required by the doctor before beginning care. This is generally covered by the insurance company.

Therapeutic Massage
May be covered or may not. The Insurance company will need to be contacted.

Supplies, Supports and Vitamins
The insurance company will need to be contacted to find out if this is a covered benefit, but generally it is not covered.

***NOTE -- Our office would be happy to call your insurance company to find out what your insurance covers. This can be done by calling our office and obtaining the proper information (562) 498-6647, or you can call your insurance company directly.

Auto Accident / Personal Injury

There are many situations in which a person can be covered for care / treatment for such an injury. The best way to find out is to call our office and speak to our staff or doctor. If an attorney is involved he will advise you also.

Our office will work with attorneys on a lien basis. This means that the attorney will be paying the doctor directly.

***NOTE -- These kinds of cases can be confusing so don't hesitate to call our office for assistance. You can also page the doctor at (562) 498-6647.

Making a false or fraudulent claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.