Financial FAQs

We do accept medical insurance though we are only in-network with BCBS PPO.  For all other insurance companies, we can help you submit claims for our services but we require payment up front.  For Aetna, Cigna, Humana and United Healthcare we can electronically submit your claims and for all other companies we can provide a superbill that you submit to your out-of-network insurance.  We do also accept Medicare through it only covers limited services. See our insurance section below.

When self paying you must pay at time of service. Prices depend on which services you get at the office. If seeing our doctors, here are the most common charges:

• New Patient Visit with our doctors: $175  (typically 40 mins to an hour and  includes new patient examination, ART, Graston, Dry Needling, Cupping, etc.)
• Regular Visit with our doctors: $90 (typically 23-30 mins hands on which includes ART, Graston, Dry Needling, Cupping, etc.)
• see Gyrotonic and Massage sections below for pricing on those services

Definitely! More and more patients have these kinds of tax exempt medical accounts and you can use that at our office for any of our services.

Insurance does not cover spa type massage, but depending on your plan benefits, you may have coverage for active clinical massage therapy or Gyrotonic therapy. You must first be a patient of one of our chiropractors to be eligible since it can only be covered if it is part of a therapeutic treatment plan.

Currently, for massage therapy and Gyrotonic we charge $110 per hour, $60 per half hour, and $50 per half hour added on to other services (such as seeing one of our doctors).  Packages of visits are available for further reduced prices.

Your appointment time is reserved just for you. A late cancellation or missed visit directly affects the therapist’s income since that spot could have been filled by another patient.  We send out a 48 hour email reminder, plus a 24 hour and a 2 hour text message reminder so you get lots of advanced notice if you need to cancel.

Our policy is that it is considered a late cancellation if:

• Canceling less than 12 hours before your appointment by web portal / online
• Canceling less than 24 hours before your appointment by phone / text / email
• Canceling less than 48 hours in advance for extended time appointments (double appointments with the doctors or massage / gyro greater than 1 hour)

We are always understanding in emergency situations and we always give at least one free unquestioned miss per year.  After that, late cancellation of an appointment may be subject to a cancellation fee.  If you are charged a late cancellation fee, the fees are as follows:

• The charge is 50% of the self-pay cost of a visit if you contact us.
• Complete no shows with no contact to us are charged at 100% of the self-pay cost of a visit.
• Extended time on a visit without 48 hours notice of cancellation may be charged 100% of the extended time fee.

Late fees and no-shows are charged to your credit card on file immediately.  If the card is declined, no further visits are allowed until the fee is paid.

At Active Body, we keep a credit card on file for your convenience and ours.  Combined with our online scheduling, this will allow you to come in for therapy, leave without having to check out at the front desk and not worry about missing a bill from us.  All patients are required to provide a credit card to be kept on file with our office.  We run our payments through our HIPAA-compliant, secure practice management software. Your payment information is stored in a PCI compliant, secure management system for future transactions, protected by Amazon Cloud technology. Office personnel will not have access to your card.

Your stored credit card will be used to pay account balances after insurance adjudication or for any self paid services.  Insurance can take 15 to 45 days to get back to us after your visit.  Once your insurance has processed your claims, they will send an Explanation of Benefits (EOB) to both you and our office showing what your total patient responsibility is. You typically receive the EOB before we do, so if you disagree with your patient responsibility amount, it is your responsibility to contact your insurance carrier immediately or contact us to help you understand their decision.

For insurance patients, any portion that you owe for deductible, copays or coinsurance, we will send you pay requests via email and text message.  These pay requests go out every 2 or 3 weeks and include the information of what you are paying for.  Once your charges are 90+ days old, if you have not paid the services already or contacted us for an alternate payment method and we have sent you at least 2 pay requests, we will then bill those charges to the credit card on file.  You will receive a detailed receipt by email.

Any patient who does not have a credit card on file will not be able to use our online booking and may be refused services.

• All patients will be required to have a credit card on file regardless of insurance or visit type.
• Ultimately, you are responsible for knowing what services are covered and how much of the cost is your responsibility. We bill your insurance as a courtesy but ultimately we have no control over what decision they make for your coverage.  You will be responsible for any portion of services that your insurance does not cover.
• You will have up to 90 days from the service date to pay  your balance using any method you prefer:  credit card, cash, or check.  Any balance due 90 days after the service date that has not been paid will be charged to the credit card on file.
• Accounts that have balances over 120+ days old without a payment plan will no longer be able to schedule.

Frequently Asked Questions:

When I booked my appointment, I was told I must keep a credit card on file with the office. I’ve never heard of that before.

Credit Card On File (CCOF) is the new standard in the healthcare industry nationwide, and soon all of the high quality medical practices will adopt it.

 

How does CCOF work? I’m nervous about giving up my sensitive financial information.

Your card information is securely protected by the credit-card processing component of our HIPAA-compliant management system. This system stores the card information for future transactions using the same sort of technology that credit card companies use. There is no way to export the card information out of our system. We can only use it to process a payment in our practice management system.

 

I always pay my bills on time. Why do I have to do this?

Nothing is changing about how much you pay or how much time you have to pay your bill. When you come into our office and receive a service, you do so with the understanding that you are responsible for the cost of your care.

 

What if there is a problem with my bill and I don’t notice it until after the payment processes?

We hope that this doesn’t happen. We routinely review the accuracy of claims processed by insurance and will contact you if we notice any problems. If you find a problem, call us and we’ll investigate it. If we owe you money, we will refund it promptly to the same card.

We are out-of-network with these and all other insurance companies besides BCBS, however, any of these companies may still re-reimburse you for services at our clinic. You will need to contact your insurance company to see if you have out of network coverage. We do not accept assignment from out-of-network insurance companies which means that you will be responsible for providing payment at the time of service and ABC can assist you in submitting these charges to your insurance company so they can reimburse you directly.   For Aetna, Cigna, Humana and Untied Healthcare patients we can submit your claim electronically for you and if they owe you money they should pay you directly.  All other companies, ABC will provide a superbill PDF with diagnosis and procedure codes directly to you for your own claim submission to your insurance.

Yes. We are in network with BCBS PPO plans. You are responsible for any copays, co-insurance and deductibles with these plans.  We will submit your claims and assist you in any way we reasonably can to help ensure that those claims are processed correctly. Your insurance company may need you to supply certain information to them directly. It is your responsibility to comply with their requests. After hearing back from your insurance company, we will send you an email and text message pay request if there is a balance due. We strongly advise that you go to your insurance company website or call them to discuss your benefit coverage for chiropractic services (such as CPT code 98941) and physical therapy done by the chiropractor (such as CPT 97110). Knowing your insurance benefits is your responsibility. Insurance coverage for these services vary greatly from plan to plan. We are always happy to help you with questions in determining your coverage but ABC cannot be held responsible if ultimately the insurance does not pay for services or provides false benefit information. Please be aware that some insurance plans may require pre-certification for chiropractic care and some out of state plans follow the rules for chiropractors in that state, not Illinois. Make sure you understand your plan’s benefits before you come in for treatment. If BCBS refuses payment or denies coverage: We will gladly work with you and your insurance company to try to rectify any problems that arise. If ultimately the insurance company does not pay, however, you are responsible for your medical bills at Active Body. If you are coming in for ‘Wellness/Maintenance Care': Even though we believe wellness/maintenance care is a great idea for everyone, please be aware that insurance companies may not pay for it. Insurance companies only want to pay for a limited amount of your acute treatment visits with a symptomatic diagnosis. Insurance may also deem care to be unnecessary if therapy is not progressing at what they consider to be a satisfactory rate and will label this as maintenance care. In this case you will have to self pay for your services at our clinic.

ACTIVE BODY is happy to help you submit claims to Medicare, but be aware that Medicare provides very limited insurance coverage at chiropractic offices. Medicare ONLY PAYS FOR CHIROPRACTIC ADJUSTMENTS to the spine and simple assessments. NOTHING ELSE is covered by Medicare.

We can bill for the chiropractic portion of your visit (i.e. CPT code 98941) which is covered at 80% by Medicare and subject to your yearly deductible *(see definition below). All other services will need to be paid at the time of service.  Please note:

• Medicare supplemental insurance may cover the other 20% of the covered Medicare charge but will still not cover Medicare non-covered procedures. If you have a true secondary insurance you may have coverage for other Medicare non-covered procedures though you should be aware that most people do NOT have medicare secondary insurance.  Supplemental insurance is the much more common type and supplemental does NOT cover anything but adjustments.
• You do have to pay your deductible if you have not met it yet for the year.
• *Deductible: This is the amount that you will have to pay before your insurance kicks in and covers the charges.  Medicare deductible for 2023 is $233 which resets on January 1.

Medicare non-covered procedures:  New Patient exams, ART, Graston, Exercise therapy, Dry Needling, Gyrotonic). Codes they don’t cover: 99203, 97110, etc.

Typically this means that Medicare will cover approximately $30 to $40 of a visit to our office.   The typical costs for Medicare patients (compared to our self pay rate):

• MEDICARE New Patient visit $145. (self pay is normally $175)
• ​MEDICARE Regular Visit with doctor $60. (typically 23 to 30 mins which includes soft tissue work.  Self pay rate is normally $90)

Medicare Advantage Plans (Medicare replacement plans):If you have one of these plans, that means you gave up having an office bill directly to Medicare and all services have to go to the company you signed up with.  BCBS Medicare Advantage plan works exactly like the regular Medicare plan, see the rules above.  If we are out of network (Aetna, Cigna, Humana, United HC) then we are not part of these plans.  In this case you would be a self pay patient ($90 per regular visit, $175 new patient).  We can then submit the claim to your insurance for you but again you pay up front at time of service. 

We do not typically accept these types of cases and we do not accept assignment for these cases (we don’t take direct payment from the insurer). You can self pay at our clinic for these case types and we will gladly supply our medical notes to your insurer or lawyer for your case. We do make some exceptions to this for patients that we already know and have a long relationship with.