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Wednesday, February 5, 2014

Obamacare: Have you heard that "health insurance" is changing? (Part One)

High-deductible plans.  Health Savings Accounts.  State Insurance Exchanges.  Oh my!!!!

If you haven't noticed, "health insurance" and "healthcare" as we know it are changing before our very eyes (assuming, of course, that the government website works on that day).  Seldom does a day pass in which a patient doesn't call or stop by our office with a question about how these changes will impact their family in the real world, and we are glad to help them sort through these pretty drastic changes in how health insurance operates for them.

Since we are getting so many questions about these topics in recent weeks, we have convinced Dr. Matt to share a little bit of information from the other side of his skill set (AKA the insurance world).  For those who don't know, Dr. Matt is a Certified Chiropractic Professional Coder and a member of the American Association of Professional Coders.  Outside of what you see him do in practice, he also uses these skills to teach other chiropractors and their staff about how to serve their patients better through proper documentation, accurate insurance billing and healthcare law compliance. 

Recently we sat down with him and put a blog series together that we hope will capitalize on his unique training and experience.  We hope to use this forum to address some of the questions that he gets asked by patients, our friends, other chiropractors and our team members on a daily basis. 

Check back over the next couple of weeks as we tackle the following questions along with many others:

What are deductibles, copays, coinsurance and out-of-pocket maximums?  How do these work in the real world and how can we determine what our insurance policies will pay versus what we must pay out of pocket?

What are health savings accounts (HSAs), health reimbursement arrangements (HRAs) and flexible spending accounts (FSAs)?  How do these work in the real world and what do we need to know in order to use them properly?  What kinds of products and services do they cover?  How do we use them to pay for our healthcare?  What does the IRS or a patient's employer have to do with a patient's massage therapy session?

What does it mean to you when your doctor decides if he or she participates in your "Obamacare" health plan or not?  From a patient's perspective, what are the advantages or disadvantages of using participating providers versus non-participating providers?

How do the changes to Kentucky Medicaid and many other insurance policies in the past few years impact chiropractic coverage?  What is preauthorization and how does your doctor's documentation of your care determine what services your insurance carrier will cover?  Why do many patients have to fill out extra paperwork just for their insurance company when they come to visit?  Why are some providers struggling to get their patient's insurance to cover necessary services just because the doctors don't know how to honestly and accurately document the high quality care that they provide? 

How do these "Obamacare" changes impact chiropractors and chiropractic patients?  Is chiropractic covered under these new plans? 

How is our office strategically positioned to help you keep your health care costs low without having to change the kind of care that we provided our patients under the old insurance system?  At Christopher Chiropractic, we have always strived to "get patients well in a way that allows them to spend as little time, money and energy as possible in our office."  Our practice model is strategically designed to accommodate high-demand insurance carriers, cash-paying patients, and "Obamacare-insured" patients without changing the care that we recommend and without fraudulently changing the fees that we charge based on a patient's insurance status.  We believe this to be one of the biggest reasons why we have been so successful.  As these "Obamacare-style" insurance plans continue to replace the old plans with flat $16.00 copays or $20.00 copays, we are confident that our approach to chiropractic and to healthcare will serve our patients even better than it has in the past. 

Check back in the next couple of days as we reveal a side of Dr. Matt that most patients never get to see.  He will explain what deductibles, copays, coinsurance and out of pocket maximums are and how they will impact you in the real world.  After that, he will be back to tackle some of those other difficult questions and help you to make sense of your new insurance plans, especially as they relate to chiropractic.

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