Dr. R. A. Foxworth, FICC, MCS-P
You know how it is. Mention “health insurance coverage for chiropractic” to your member doctors and they don’t know whether to laugh or cry.
We don’t have to tell you that coverage for chiropractic is woefully inadequate. Despite numerous studies that demonstrate the effectiveness of chiropractic, particularly for pain management, insurers can seem blind to this information. In fact, that’s the focus by the American Chiropractic Association for October’s National Chiropractic Month. Many private insurers offer some degree of coverage but cap the number of visits per year, often at a ridiculously small number. Medicare will pay for chiropractic as long as the care meets its guidelines for medical necessity.
In the meantime, the debate over whether to improve health insurance coverage for chiropractic, and how, rages on. A study published by the National Institutes of Health sums it up. “Information is needed to inform the decisions of chiropractic leaders and Medicare policymakers who want to provide better care, improve health, and lower costs for the growing population of Medicare beneficiaries with spinal pain disorders.”
It’s great that all this is being examined, but what are patients and providers to do in the meantime? Here we are, at the beginning of the fourth quarter, and many chiropractic patients have exhausted their health insurance benefits for the year. Are they simply supposed to suffer until 2017’s benefits kick in?
Your members know that when health insurance coverage runs out, most patients run out the door. But what if your member doctors could tell patients that they can pay the same amount as their co-pays or less, even after their insurance benefits hit a wall? What if you could tell your members that they could not only make that possible, but offer legal discounts without worrying about violations associated with inducements, dual fee schedules, or improper time-of-service discounts?
ChiroHealthUSA is a provider-owned network that allows providers to charge patients the same or even less than their insurance co-pays year-round, regardless of whether or not those insurance benefits have been exhausted for the year. Designed with doctors in mind, our network model works in conjunction with a Discount Medical Plan Organization (DMPO) so your association members can offer legal, network-based discounts to not just the under-insured, but also to cash and “out of network” patients who become members.
It’s easy for your members to join as a provider. There’s no cost to the chiropractor or the practice and it’s easy for your association members to explain to their patients. Patients quickly learn how paying an annual membership fee of $49 for ChiroHealthUSA entitles them to network discounts on their services. It’s a win for them, because the cost of their memberships is usually more than made up in the very first visit. And it’s a win for you, because you have a way to offer legal discounts to patients in need.
Urge your members to take action instead of waiting for policymakers and legislation to work things out. Invite them to visit chirohealthusa.com, where they can find out more about how becoming a ChiroHealthUSA provider allows them to help patients pay for the care they need and deserve.
▶︎ 
Why is the Discount Challenge prize amount $15,024? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $15,024 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.