“Do You Accept My Insurance?”

A lot of people want chiropractic care, but only if it’s covered by insurance. Some people have it made up in their minds that they will only go to doctors who accept their particular plan… so it should come as no surprise how often chiropractors hear the question, “Do you accept my insurance?”

Using insurance for visits to your medical doctor can be different than using it for visits to your chiropractor though. In fact, you might be surprised to find out the true cost of insurance when we run the numbers.

A good friend of mine is a very successful “full spine” chiropractor who I’ve known for about nine years. Recently we discussed how much he dislikes accepting insurance, and how long it can take for him to get paid.

He said that every year insurance companies find ways to reduce reimbursement amounts, and that patient co-pays are getting higher. The average co-pay in his office is $30; it used to be $15. More and more of his patients have co-pays exceeding $40! He feels that when the average co-pay becomes $45, it will no longer be worth his time and effort to participate.

During our conversation, I asked my “full spine” friend how many times he sees the average new patient within eight weeks. Without delay he quickly said, “20-24 times.”

Let’s split the difference and say 22 times. If his figures are correct, then the average patient coughs up a $30 co-pay during each of their 22 visits… Over the course of eight weeks, the “out of pocket” expense for visiting my chiropractic colleague who “accepts insurance” would be $660.

When he asked me the same question, I told him that it depends entirely upon the patient, but ranges anywhere from 2-8 visits. Splitting the difference, their out of pocket expense for five visits is $375 (not to mention the reimbursement they get with out-of-network benefits, which could make this as much as $250 cheaper!)

Now, I’m not suggesting that one method of chiropractic is superior to another… But the average patient doesn’t realize that the number of visits in one type of chiropractic office could be as much as 3-10x less than another.

And we can’t forget the time factor… How much time is required to make 22 trips to the chiropractor? If the average visit takes 10-minutes, it’s 220 minutes, excluding round-trip commute. What’s 3.7 hours of your time worth?

If that wasn’t enough, the more often you make use of your insurance, the higher next year’s premium will be… You might be paying $130 per month for insurance in 2009, but if you use it 20-24 times, chances are you’ll be paying more in 2010.

So the question that patients ultimately need to be asking isn’t, “Do you accept my insurance,” but more importantly, “Is using my insurance really worth it?”