Insurance

What You Need To Know

Who Are We In-Network With

BCBS

Blue Choice Options
Preferred Provider Organization
Blue Choice PPO Preferred
Professional Blue Choice PPO

Cigna

United Health Care

Veterans Affairs

Insurance health financial collection

All co-pays, co-insurance, and any items not covered by insurance are due upon invoice once your claim has been processed. Until your deductibles are met, plan to pay out-of-pocket the insurance contracted rate for services.

We will keep a credit card on file. This makes for easier collection of missed appointments or late cancellation fees. This will also ensure you are charged the correct amount after an insurance claim has been processed.

Specialty Lab Work & Supplements

Patients may be prescribed specialty lab work through Rupar, physician-grade supplements, and/or herbs. These labs and supplements are not covered by insurance at Root Therapeutics but may be eligible for reimbursement through a Supperbill or by using FSA or HSA.

Denial Of Benefits

Why your benefits might be denied even though you have coverage:

Your benefits may say you have acupuncture coverage, but it may depend on who is performing it (medical doctor, chiropractor, or licensed acupuncturist). Often we don’t find this out until it is denied.
Even though you have acupuncture coverage, not all insurance companies accept the same ICD codes, and unfortunately they can vary vastly between insurances. We also don’t usually learn this until a claim has been denied. If this happens, we will attempt to work with the insurance companies to resubmit the claim.
Insurance needs to be reverified every year. Even though you didn’t change your policy, policies do change over time to include more treatments or to remove them

Massage Benefits

When your plans says you have massage coverage:

Doesn't cover a 60 minute session
Normally a 30 minute session that is considered physical therapy
Normally working with a chiropractor or physical therapist for this
Make sure to ask what kind of massage coverage you have and who you can see, not just who is in-network
We are not in-network for this type of massage at Root Therapeutics but it may be eligible for reimbursement through a Supperbill or by using FSA or HSA.

Verification Of Benefits (VOB)

Verifying your insurance is the first step in becoming a new patient at Root Therapeutics. Upon completion of creating your patient portal, entering in all your demographics, and uploading pictures of your driver’s license and front and back of your insurance card, we will start the verification process. Until your insurance is verified, any appointments booked will remain in a pending status. Once your insurance is verified, you will receive a document going over your ESTIMATED benefits and financial responsibility to be e-signed.

If we discover that we are out of network for you, we can provide you with a Superbill. This is documentation you will need to submit to your insurance company for possible direct reimbursement to you. This will be found in your patient portal.

Other Payment Options

Flexible Spending Accounts & Health Reimbursement Accounts Our services are eligible for most flexible spending accounts (FSA), health savings accounts (HSA), and health reimbursement accounts (HRA).

Self Pay Packages Many of our services have the option for monthly memberships & packages. These are available in your patient portal at the time of booking or can be done in person at the time of your visit.

Definitions

Covered Services: those healthcare services specified and defined as Covered Services under the terms of a Covered Person’s Health Plan.

Coinsurance: if applicable, the specified percentage of the fee for a Covered Service, that is payable by the Covered Person.

Co-payment: the amount required to be paid to the Contracting Provider by or on behalf of a Covered Person in connection with the services rendered by the Contracting Provider.

Deductible: if applicable, the specified annual amount of payment for certain Covered Services, expressed in dollars, that the Covered Person is required to pay before the Covered Person can receive any benefits for the Covered Services to which the Deductible applies.

In-Network Provider: a Provider of health care services that has an agreement with a specified Health Care Plan.

Out-of-Network Provider: a provider of healthcare services that does not have an agreement with a specified Health Care Plan.

Superbill: is essentially a receipt for services rendered, that a patient has paid out of pocket for with an Out-of-Network provider. Patients must submit this document that contains vital information, such as diagnostic and procedure codes, needed for insurance companies to possibly reimburse patients rather than providers.

Payor: an entity other than specified Health Care Plan that is financially responsible for payment for Covered Services under a Health Plan.