chiropractic rip-off?

[Harley's-mom]

What is the name of your state? What is the name of your state? CA
I received treatment from a chiropractor for an auto accident injury. My group insurance was billed first. I'm allowed 20 chiro visits per year. I had a total of 30 visits. By rights I should only owe for 10 visits.
The chiro office says they want 100% no negotiations, including the balance on the unpaid portion of my 20 visits, which normally gets written off, and was clearly stated on my statements, I am not financially responsible for.
Can they do this?

 

[I AM ALWAYS LIABLE]

What is the name of your state? What is the name of your state? CA
I received treatment from a chiropractor for an auto accident injury. My group insurance was billed first. I'm allowed 20 chiro visits per year. I had a total of 30 visits. By rights I should only owe for 10 visits.
The chiro office says they want 100% no negotiations, including the balance on the unpaid portion of my 20 visits, which normally gets written off, and was clearly stated on my statements, I am not financially responsible for.
Can they do this?

My response:

Where are you getting this "normally" jazz? And, who says there's a rule about the balance getting "written off"?

The chiropractic office isn't under contract to the insurance company. If your insurance pays $20.00 per visit, and the Chiro office charges $40.00 per visit, then you're on the hook for the balance for each visit.

Perhaps you should explain the situation a little better, and tell me if the Chiro office is a "Network Provider" under your insurance policy.

IAAL

 

[Harley's-mom]

If I were to go to the chiropractor, 20 times in one year, all I pay is my co-pay, nothing else, therefore, shouldn't I be responsible only for the remaining 10 visits? The chiro is a "network provider" under our insurance policy.

 

[cbg]

Assuming that the facts you have provided about your insurance policy are correct, I would agree with your assessment of the situation.

What you want to do is contact the insurance carrier (they will have a deparment to handle issues like this - in the one I worked for it was called Provider Relations) and tell them that while you realize you have exceeded your limited benefit and that you are responsible for the excess visits, the provider is attempting to "balance bill" you for the covered 20. They will tell you what to do from there, according to their procedures for dealing with providers in this situation.