Craven Chiropractic Discount Fee Program
We found a need to address the issue of high deductibles, outrageous co-pays and even non-coverage for certain services. More and more of the financial burden of health care has been passed onto the patients by the insurance companies. The reality is there are strict laws about offering discounted fees. This program puts us in compliance with state and federal laws.
We have seen co-pays that are way in excess of what we can provide the service at a discounted price. Or you may have a deductible for which you are 100% responsible for, therefore you are a cash patient anyway. This program will save you money in those cases.
There is an example about Medicare
referenced later in the FAQ’s section.
Briefly, a new patient that needed a full work up, would be charged $50 for an exam and $50 for all x-rays necessary. Some patients may only need a $25 brief exam. The chiropractic adjustment fee is $30, any therapies added to that would be $10.
We will address any additional question at the time of your appointment, so you have a clear understanding if Patient Options is a good choice for you.
What is Patient Options?
Patient Options is a discount managed care organization not unlike other you may have heard of. Its network of Providers is legally able to offer their self-pay patients a discount. Patients join for free and receive discounted care from network providers. Do to our high volume of patients utilizing this service we are contracted at a fixed expense to provide this service for you. It’s like a “Sam’s Club” or “Costco Membership” for your chiropractic care except we pay the membership fee for you.
Why was Patient Options formed?
Health care attorneys and other private and federal compliance specialists formed Patient Options to fulfill a need in the health care delivery system given today’s complex legal compliance environment. The Federal government and private insurance companies have stepped up auditing, regulation and enforcement actions targeting providers of all types while patients’ out-of-pocket expenses have increased. Patient Options was formed for the benefit of all parties involved.
How do patients receive a discount under Patient Options?
Patients receive a discount based on the providers’ fee schedule registered with Patient Options. This solves a problem of an illegal dual fee schedule, because Discounts are offered by Patient Options network providers, much like many other preferred providers, HMO or third-party administrator discounts. Unlike a traditional discount medical plan organization, there is no fee for the patient to join. Why should patients have to “pay more to pay less?” Patient Options lessens the financial burden on patients.
Do patients have to show participation status prior to getting care?
No. The doctor who is a contracted provider with Patient Options would have a signed patient participation agreement in the patient’s file as well as a copy on file in the Patient Options database. As long as the patient is enrolled and the doctor is a network provider, they are good to go!
Is Patient Options health insurance?
Patient Options is not health insurance as construed under the Affordable Care Act, but it is a discount managed care organization designed to benefit patients in need of care.
Can Patient Options be used in conjunction with health insurance?
While patients can be a participant of Patient Options and a health insurance plan, the insurance company is billed for their covered services and the patient pays the discounted fee for non-covered services. EXAMPLE: Medicare pays for only a chiropractic adjustment. Any exams, x-rays or therapy would be paid at a discount through the Patient Options Plan.
Want to know how bizarre these laws are? If a doctor provides a non-covered
service, at “No Charge”, it is considered INSURANCE FRAUD under
Medicare and Medicaid laws!!!!!!!
How much does it cost patients to join Patient Options?
Zero! We think it is important that providers nurture relationships with patients, not create unnecessary and costly hoops to jump through in order to receive care. In simple terms, providers and patients alike hate having patients “pay more to pay less” as in typical discount medical plans.
Will the patients’ privacy be protected?
Yes. Patient privacy is very important to us, as it should be, and we abide by all privacy laws and regulations.