Tel: (860) 482-5479459 Prospect St,Torrington, CT

Insurance / Financial

The changing landscape of healthcare has forced Downs Chiropractic to be selective about which insurance plans and third party payors we do business with. The sad reality is that various insurance carriers utilize subcontractors or third party administrators to handle chiropractic claims. Such plans are characterized by poor reimbursement to providers, or administrative paperwork burdens that are in place to effectively limit patient access. Dr. Downs has chosen to avoid plans, which by design, interfere with the doctor/patient dynamic.

The commercial plans in which we currently participate are the following:
• Blue Cross/Blue Shield
• Cigna PPO
• Cigna Open Access (City of Torrington employees only)
• ConnectiCare plans (except ConnectiCare Medicare)
• Healthy CT plans

Fee-For-Service Arrangements:
Recognizing that a number of popular insurance plans are omitted from the above list of insurers, we have striven to provide reasonable fees for those patients who have a plan in which we do not participate. Our pricing parallels the copayment arrangements intrinsic to many of the plans we do not participate with, thus “out-of-network” costs are similar to those of an “in-network” provider. Since payments are made at the time of service, a discount can be applied to yield the following fee schedule: 

New Patient Evaluation: $85.00
Follow-Up Visits: $45.00
Acupuncture Visits: $50.00
Dry Needling (1 region): $47.00
Dry Needling (multiple regions): $65.00
Myofascial Release (30 minutes): $30.00
New Patient Medicare Exam:  $85.00 (non-reembursable)
All followup Medicare visits (spinal adjustments):  $32.23

Medicare Participation and Policies:
Dr. Downs is an enrolled provider in government administrated Medicare plans. As an enrolled provider, we have the choice of being:

  • Fully participating – which means we accept assignment on all Medicare claims. This mandates that we send in the claims on your behalf and wait (often months) for Medicare to send us reimbursement.
      • Non-participating – meaning we do not have to accept assignment. In this case, patients make payment at the time of service, then we are obligated to send in the claim on the patient’s behalf and Medicare reimbursement should be sent to the patient directly. When Medicare reimburses (after the deductible is satisfied) they currently reimburse approximately 80% of $28.03, yielding about $21.97 of a $32.23 visit. The secondary policy, if one exists, will usually pay the remaining $5.61 or 20% of the allowed fee, depending on the policy. Please note the Medicare fees can change on a year-to-year basis, which would mildly skew the above referenced numbers.

On a final note, it should be pointed out that Medicare does not pay for an initial New Patient Exam and this applies to both participating and non-participating chiropractic providers. The following fee schedule, payable at the time of service, thusly applies:

      • New Patient Medicare Exam: $85.00 (non-reimbursable)
      • All followup visits (spinal adjustments): $32.23

We know Medicare claims administration can be confusing and has been changing with ObamaCare, so if you have any further questions concerning Medicare, please call or email Eleanor.

Payment Policies:
Payment for services to be rendered are handled upon entry to the office. This prevents congestion at the front desk and provides better administrative efficiency for our office. Patients who are unprepared to make payment on the day of service, will be asked to reschedule accordingly.

Payment Options:
• Cash
• Personal Check
• HSA Cards
• MasterCard – credit or debit
• Visa – credit or debit
• Discover – credit or debit