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HEALTH INSURANCE

Insurance, in plain English.

Insurance is confusing on purpose — and confusion is where the surprise bills come from. So here’s the whole thing, step by step, before you ever walk in.

First, three words that cost people money

If you understand these three, you understand 90% of your bill.

Deductible

What you pay before insurance pays anything.

$1,500 deductible = you cover the first $1,500 of care this year.

Copay

A flat fee per visit your plan sets. By contract, we can’t waive or discount it.

$30 copay = $30 every visit, no matter what.

Coinsurance

Your percentage share after the deductible’s met. Your insurer sets it after we bill.

20% coinsurance = you pay 20% of the visit.

How your visit actually gets paid

Four steps. That’s it.

You come in and we treat you

We collect your copay if your plan has one.

We bill your insurance

We send the claim for you — no paperwork on your end.

Insurance decides their share

They apply your deductible and coinsurance and pay their part.

Anything left is your balance

If there’s a remainder, we’ll bill you — and we’ll always explain why.

THE PART WE’VE ALL BEEN TRAINED TO MISS

Health insurance isn’t health care.

We’ve been quietly taught that if insurance won’t pay for it, it must not be “real” healthcare. That’s backwards — and it’s a whole chapter in Edge Cracking.

Insurance tells you what it will pay for. It doesn’t tell you what helps your body.
The same technique — billed by a physical therapist, covered; billed by a licensed massage therapist, not. The hands didn’t change. The billing code did.
“Not covered” doesn’t mean “not care.” It means not reimbursed.
Your dentist doesn’t wait for a tooth to abscess before cleaning it. Neither should your spine.

Do we take your plan?

Here’s the honest list for chiropractic care. Don’t see yours? Keep reading — you’ve still got good options.

MOST PLANS — WE’VE GOT YOU

We’re in-network with

These bill straight through — nothing extra for you to do.

  • Advantra Freedom
  • Aetna
  • American Specialty Health (ASHN)
  • Berkshire Health Plans
  • Capital Blue Cross (not Blue Cross Blue Shield)
  • Cigna
  • Coresource
  • Coventry / First Health
  • Golden Rule
  • HealthAmerica
  • Humana
  • Loomis
  • Meritain Health
  • Most Medicare (all states)
  • MultiPlan
  • Oxford Health Plans
  • Railroad Medicare
  • Tower Health
  • UMR
  • Wellspan
A FEW WE DON’T

Out-Of-Network

We can still help — here’s how.

Highmark BCBS
We’re genuinely sad about this one — there’s a real story here.
Read the full story →
  • Certain Medicare plans
  • Geisinger
  • Horizon BCBS (NJ)
  • Independence / IBC
  • Keystone
  • Medicaid
  • Personal Choice
  • Teamsters
  • UHC
  • UPMC
How to submit your own bill to your insurance companyA step-by-step guide for filing out-of-network claims yourself, so you can still get reimbursed.Coming soon

Why A Bill Can Still Show Up — It’s Your Plan, Not Us

If a statement lands later, it’s almost always your insurance doing insurance things — not a charge we added. The usual reasons:

1

Your deductible isn’t met yet, so your plan counts this visit toward it — that’s how a deductible works, not an extra fee from us.

2

Your insurer calculates a coinsurance share after the visit, so it isn’t always collectible at the desk — it can arrive on a later statement from them.

3

Your insurer denied or downgraded a visit. Insurance companies make their own coverage calls — sometimes arbitrary ones — and that part is out of our hands.

4

You’ve hit the visit limit your plan authorized for the year. That cap is set by your insurance, not by us.

Hate surprises? You can skip insurance entirely and pay our flat cash rate — you’ll know the exact cost up front, every time.
FAQ
DON’T SEE YOUR PLAN? — FOR OUT-OF-NETWORK PATIENTS

You can still come in — and still get reimbursed↑Maybe…Insurance companies are squirrelly >_<.

If we’re out-of-network with your insurance, you pay our cash rate and we hand you everything you need to file with your own carrier for reimbursement. Many plans pay you back a good chunk — you just have to submit it.

1. Pay The Cash RateYou’re seen like any patient.
2. We Give You A SuperbillAn itemized receipt with the codes your insurer needs.
3. You Submit ItSend it to your carrier’s out-of-network claims and they reimburse you.

Questions people actually ask

What’s a superbill?
An itemized receipt with the diagnosis and procedure codes your insurer needs — the same information a clinic would send them. You’re just the one sending it.
How much do I get back?
Depends entirely on your plan’s out-of-network benefit. Some pay a good chunk; some pay nothing until a separate out-of-network deductible is met. Call the number on your card and ask.
How long does it take?
Usually a few weeks once they have it. If you haven’t heard in 30 days, call — claims genuinely do get lost, and a polite follow-up moves things along.
Do you submit it for me?
Not when we’re out-of-network with your plan — we can’t bill a carrier we don’t contract with. We hand you everything they need.
Impact Health Sharing
⚡ TIRED OF YOUR INSURANCE?

There’s a better way — Impact Health Sharing.

Paying a fortune for a giant deductible and a maze of “out-of-network”? With Impact, there is no out-of-network — everybody’s in. It’s what Dr. Smith uses for his own family — and offers it to eligible team members at the office.

Case in point: Dr. Smith pays less than $650/month for his own family of four, with a $2,500 deductible — and zero providers “in-network,” because there’s no network to be in or out of.

0out-of-network
120%of Medicare paid
2easy steps
Option A — Direct BillingThe office submits it directly to Impact — reimbursed at 120% of what Medicare pays, and Impact negotiates the price down on your behalf.
Option B — Pay & FileYou pay us directly and submit it yourself through the Impact portal — takes about five seconds, and you’ll typically get a large portion back.

Curious if it’d save your family money? Take a look — no pressure.

Explore Impact Health Sharing →