Couple

INSURANCE INFORMATION

Dr. Holderegger is IN NETWORK with the following insurance companies:

Aetna
Regence Blue Cross/ Blue Shield
Cigna
Great West Healthcare
HealthNet
Kaiser
Lifewise
ODS
Providence
PacifiCare

Pacific Source
United Healthcare

Some insurance companies use a third party company for their alternative medicine coverage. We are IN NETWORK with:

American Specialty Health Network (ASHN)

CHP
Healthways
OptumHealth

MEDICARE

Your Medicare coverage of chiropractic care is limited. It does not pay for all services. It will only pay for your chiropractic adjustment (manipulative treatment) when it meets Medicare’s specific rules. There are three categories of Medicare services: 1) non-covered 2) always-covered, and 3) perhaps-covered.

NON-COVERED Services

According to existing Medicare law, most of the services in our office are NON-COVERED. Hopefully, the U.S. Congress will change that someday and treat Doctors of Chiropractic like all other doctors. Until then, here is a summary:

Examples of Non-Covered Services:
All Services Other than Chiropractic Adjustments:

• Office Visits - to evaluate and manage, re-evaluate, advise, or give counsel regarding your health. This includes physical examinations.
• Physiotherapy - such as massage, traction, electrical stimulation, neuromuscular
re-education, etc.
• X-rays, Laboratory, Supplies, Vitamins, etc.
• Non-spinal manipulation to the shoulder, arm, leg, etc.
• Maintenance Care - you are stable and not making any more improvement.
• Wellness Care - to promote better health.

ALWAYS-COVERED Services

A Medicare COVERED service is for when you are injured or when you are in pain due to a bad spinal condition. Medicare pays for your rehabilitation as long as you are improving. This phase of care is call “active treatment.“ It will be shown on your Medicare claim form and payment reports with your service code. For example, “98940-AT.”

PERHAPS-COVERED Services

Your Chiropractic Adjustment must be clinically needed to correct a problem of the spine, according to Medicare rules. If Medicare determines that treatment for your condition is not “Medically Necessary” they will not pay. When we know or believe that your chiropractic adjustment is no longer covered, we will discuss this matter with you. We will also give you a Medicare form known as the Advance Beneficiary Notice (ABN) which will show your financial obligation for continued care.

We are a participating provider with Medicare. We will bill Medicare for the services they cover. You will be asked to pay your co-payment as well as the charges for non-covered services at the time of your visit, unless you have secondary insurance that coveres these services.