INSURANCE FAQs

Coverage and Care

YOUR COVERAGE

Most insurance policies cover only a portion of the initial stage of your care, designed to reduce your symptoms and improve function. Every policy is different. We’ll help confirm your specific benefits.

OUR EXAMINATION

We’ll confirm whether your case can be treated at Birmingham Health. It is necessary to undergo our exam to find the underlying cause and location of your problem. Many say it’s the most thorough exam they’ve ever had. Expect a complete report of our findings and specific recommendations.

YOUR DEDUCTIBLE

Most carriers require that you meet a deductible amount each year before they assume financial responsibility. Have you met your deductible this year? If not, we’ll work with you to find an affordable solution. If you have a Health Savings Account or a Health Reimbursement Account, use it to offset your out-of-pocket expense.

YOUR CO-PAY

These days, most insurance carriers expect you to assume some financial responsibility by contributing what’s called a co-pay. This “co-insurance” can be a flat fee or a percentage of the cost of a particular service or office visit.

MEDICAL NECESSITY

For your insurance carrier to participate, they require that your care be “medically necessary”. That means:
1.  Your treatments must relate to your particular health complaint.
2. Your treatments must hold the promise of making functional improvements and
3.  You faithfully follow your doctor’s treatment plan.

MAXIMUM IMPROVEMENT

The number of treatments covered by each health insurance policy varies. It depends upon the severity of your condition. Sometimes, more visits will be needed than what your policy covers. If continued care seems promising to you (but not to your carrier), you will be encouraged to pay for it yourself. We’ll work with you to help make it affordable.

FUNCTIONAL IMPROVEMENT

Instead of judging your progress by how you feel, your insurance carrier expects to see improved function. That means a restored ability to turn, bend, walk, sleep, or perform, activities of daily living.

MAINTENANCE CARE

Most insurance policies don’t pay for care designed to maintain your progress or help prevent future problems. This preventative care, similar to brushing and flossing your teeth, may help avoid future problems. That’s why many of our patients wisely choose to pay for such care themselves. It helps them to stay well and avoid a relapse.