Do medical insurance companies reimburse for chiropractic treatments?
Chiropractic medicine is recognized as one of the few healing arts that have been proven effective. Because of this, many insurance companies cover the services provided by chiropractic physicians. Some insurance plans cover the cost of these services in their entirety, while others only cover a few visits. It is the chiropractors' discretion as to whether they want to work with insurance companies or only accept direct payment from clients.
"Some of the benefits of contracting with an insurer are: referrals from provider directories for payers and steady income with minimal patient billing," said a representative with the American Chiropractic Association. "The drawbacks include doctors of chiropractic (DCs) may receive reduced reimbursement when in-network with a payer and DCs have to keep track of varying payer policies/network pre-authorization requirements."
However, the ACA notes that this is general information and that it does not give advice to its members as to whether they should or should not join a particular insurer or network.
"These are personal business decisions that each provider would have to consider given his or her situation," the ACA representative said.
What is a chiropractic adjustment?
The ACA reports that the terms "adjustment" and "manipulation" are generally used interchangeably, although some people may make minor distinctions.
"Manipulation is considered the technical term, and is the word used in CPT [Current Procedural Terminology] codes to describe the procedure," the ACA representative said.
The ACA describes an adjustment as occurring when a chiropractic physician uses his or her hands to manipulate the body's joints and, more pointedly, the spine. These adjustments help in restoring and enhancing the body's joint functions. If you are in more need of details about adjustments, you can find information on the ACA's Frequently Asked Questions page.
Will insurance companies be more accepting of chiropractic insurance claims in the future?
"Our hope and belief is that Section 2706 of the Patient Protection and Affordable Healthcare Act (PPACA) will lead more payers to reimburse DCs for the services they are licensed to perform," said the ACA representative. "Section 2706 is a provision of PPACA, entitled NONDISCRIMINATION IN HEALTH CARE, that will prevent insurance companies and health plans from arbitrarily excluding the participation of doctors of chiropractic, and the services they provide, in their health plans."
More information on Section 2706 can be found on the ACA website.
- Interview with ACA representative, May 29, 2015. American Chiropractic Association.