Insurance

You can contact your Patient Service Advocate to discuss available payment options.

All monies paid at time of service are held on your account until your insurance processes your claims.

Once your insurance processes your claim we apply your up front payments, once a claim is paid in full it does not show on your statement. Therefore you don’t see your payment.

The money you pay at each visit is a portion going towards your ending balance, and it will not cover all of your expenses. The money you pay at each visit goes toward your ending balance and decreases the total amount you will have to pay in the end. This is a way to decrease the chance of having a financial burden on you and your family after you have completed treatment.

No, your charges will be determined after each visit and are based on specific treatment plans and codes. You may contact your Patient Service Advocate at 715.635.2518 (Spooner) or 715.699.1371 (Hayward) to discuss any questions you may have.

Yes, all services provided must be paid in full by either your insurance plan or yourself.

Some insurance plans will have a maximum that they will pay towards your therapy.

No, we quoted your benefits only. We are unaware of prior charges through another facility.

I thought my insurance covered everything 100%?
A. There may be services which are non-covered under your plan which can’t be determined until your claims have been processed by your insurance company. When we verify your benefits we obtain plan coverage. However, we are not always aware of services that will be denied by your insurance plan.

If you have coinsurance:
A coinsurance is a percentage determined by your insurance plan that you the patient will be responsible for once the insurance has processed the claim.

For example:
If your coverage is 90/10 this would mean you are responsible for 10% of the allowed charges. Therefore, we ask you, the patient, to pay $15.00 at each visit, the $15.00 will be applied to your ending balance, which is determined once your insurance processed your claims.

If you have copay:
A copay is a set dollar amount determined by your insurance plan that is due at each visit.

For example:
If your insurance plan requires a per visit copay of $15.00, this will be required each time you are treated.

Retaining an attorney is completely up to each individual. Attorneys can often help you maneuver through the legal red tape, but in some cases, the patient can work directly with the insurance company. Once you give us your attorney’s name, we will communicate and follow up at least every 30-90 days with that office. We keep each other updated on the status of your case. Usually the attorney will request Medical Records from us when your case is close to settling and a demand goes out.

A Lien is voluntary and is basically a promise by the patient to protect our interests in the event of a settlement. A letter of protection is a document that we receive from your attorney, stating that he/she will protect our interests at the time of settlement. Your attorney will need your authorization to give us this letter so he/she can pay us out of the settlement proceeds.

When your case goes into litigation, it means that your attorney was not able to settle the case. Now the case will be tried, and the court will decide who will be held liable.

Cases usually don’t settle until you are done with treatment and have been released from care by your treating physicians. Settlement is when you and the other party come to an agreement. At that time all your medical bills will be paid and you are relinquishing any right to go back for additional reimbursement.

If we are given the information for that Insurance Company, we usually mail a Lien to them, and if you give your authorization they will cut us a check upon time of settlement.

We bill you on a monthly basis to make you aware of the status of your account. Although we render billing service to you as a courtesy, you are still responsible for any outstanding charges.

Due to the Statute of Limitations, which vary from state to state, litigated accounts may take up to 2-3 years to get settled. Therefore we ask you to make minimum monthly payments to keep your account current. Payments are due until the case has settled or the account has been paid in full.

We will make all possible attempts to get your account paid in full, and leave you with minimal out-of-pocket expenses.

Since all insurance companies are reimbursed 100% by the at-fault party’s insurance, paperwork may be kept to a minimum through your auto insurance policy, rather than your health insurance.

The reason we ask for additional insurance information is because most insurance companies ask you to obtain a referral or authorization from your doctor prior to initiating treatment at our facility. Insurance companies and doctor’s offices do not give back-dated referrals or authorizations for treatment. Also, medical coverage on your auto policy may have a limited amount of money to pay out and once that is exhausted we can bill your health insurance for the difference.

It depends on whether you have Medical Pay coverage on your auto insurance and what your health insurance coverage benefits are. If your health insurance has restrictions, such as calendar year maximums, limitations on the visits, etc., you may choose your auto insurance to be primary so that your health insurance is available for other injuries. Also, most health insurance plans will have you complete multiple subrogation forms, accident details, etc., so it may be easier to use your auto insurance.

If you do not file a claim with your own insurance company we will be unable to bill them. You may have health insurance that we can bill, but usually your attorney will ask you to go through all avenues of insurance reimbursement before they will litigate the balance.

We can bill them, but they will not pay us until time of settlement. This is the time when we would ask our patient to sign a Lien, which we will forward to the other parties insurance company. Once settlement has been reached, generally the balance is paid in full. We will require minimum monthly payments to keep your account in a current status.

Once you have retained an Attorney, you will find that he/she will utilize all Insurance Policies available in order to minimize the patient balance at time of settlement. Actually, it is beneficial to you for us to not bill your attorney because if he/she has to review each date of service you will be billed for the time spent. Our Team of Specialists will stay in contact with your attorney and make sure that he/she is aware of the charges.

We will make all possible attempts to get your account paid in full, and leave you with minimal out-of-pocket expenses.