Insurance/Auto Accident FAQ

 

TO USE your INSURANCE OR NOT USE your INSURANCE?

That is the question. Other questions and answers that our patients have had about insurance can be found below! Flourish also accepts cash, check, and most major credit cards.

 

1. Are you in-network with my insurance plan?

 

We are in-network with the following insurance companies:

  • Premera

  • Regence

  • First Choice

  • Aetna

  • Cigna

  • United Healthcare

  • Kaiser Permanente*

  • L&I (Department of Labor & Industries)

 

*Kaiser Permanente has two different types of classifications. If your insurance card shows “First Choice Health Network" on the front of the card, then we are able to accept your insurance. If your insurance card does not indicate “First Choice Health Network”, then we are not in-network with your plan.

 

We are not accepting any new Medicare patients.

 

Please note: Washington Apple Health and other Medicaid programs do not typically cover chiropractic services.

 

2. What does my insurance plan cover?

 

Great question! We HIGHLY recommend that you contact your insurance company personally to have them explain your specific benefits to you before your first appointment. While we can access certain information from your plan online, we can’t always see the fine details for each service. Each person’s plan is like a snowflake, unique and intricate (like you!).

We can never guarantee coverage. All we can do is bill out to the insurance company and await their response.

*Some insurance plans, while they may cover chiropractic treatment, will not cover certain codes that we utilize for physical therapy and muscle work in our chiropractic sessions. This is based off the plan and insurance provider you chose for your healthcare needs. Please refer to our Patient Contract for more information.

 

3. How much will my appointments cost?

 

Cost for services will always depend on your individual insurance plan. Each person’s deductible, copay, coinsurance, etc. is different depending on the elections you made during your enrollment period for your insurance plan. Remember the snowflakes we just talked about?

We are happy to try and look up this information for you, but again, it’s always best to verify this information with your insurance company directly. Disclaimer: We can never guarantee coverage or payment by the insurance company.

 

4. What’s a deductible?

 

(noun): a specified amount of money that the insured (that’s you) must pay before an insurance company will pay a claim.

For example: If your plan specifies that you have a $500 deductible, you would be responsible to fully pay for any medical costs up to $500 before your insurance company will pay towards a claim.

Deductibles reset once a year; typically, on January 1st. However, some companies have different plan years. i.e. Benefits for Amazon employees run from April 1st – March 31st each year.

 

5. What's a coinsurance?

 

Some plans will include a coinsurance % after a deductible has been met.

This means that once you have satisfied your deductible, you may still be responsible for a small percentage of your medical bills.

For example: If your coinsurance is 10% and a claim is approved for $59.00, you are responsible for $5.90, while the insurance company would pay $53.10.

 

6. I was involved in a car accident. Can I use my auto insurance to pay for my treatment?

 

Medical bills associated with car accident injuries can be paid using your auto insurance policy only if your plain includes Personal Injury Protection (PIP). You can contact your claims adjuster or auto insurance carrier to verify your PIP amount for the accident towards medical costs.

 

7. What if I don’t have PIP coverage? Or what if the accident isn’t my fault?

 

If you do not have PIP coverage, you will need to utilize your private health insurance for treatment. You would still be responsible for any balances not covered by your health insurance policy.

If you were involved in an accident where you are not at fault and you wish to use the At-Fault parties’ PIP coverage to pay for your medical expenses, this is classified as a 3rd Party auto accident case.

We hold the right to accept third party cases on a case by case basis. Third party cases sometimes take years to reconcile. We are smaller offices that offer quality one-on-one care. For this, we have a maximum number of third party cases we can accept at a given time. We would require that you sign a medical lien against your settlement to ensure payment to our office once your case has been settled. Please call our main office to inquire if we are currently accepting new third party cases.