Insurance and Fees

Insurance is daunting…

We are here to help!

We understand that insurance is difficult to navigate which is why we make it as easy as we can.  If you call our office with your insurance information we would be happy to verify your benefits for you and explain them.  While we strive to answer most insurance verification requests the same day, due to changes in the insurance industry, wait times for many insurance companies have increased and may cause a delay in verification of your benefits. If you have questions about your benefits or payment, please call (503) 344-6711.


Milwaukie Spine and Sport, LLC is a Preferred Provider for MOST major Medical Insurance companies.

  • Aetna
  • American Specialty Health
  • Blue Cross/Blue Shield (Regence)
  • Kaiser/CHP
  • Lifewise of Oregon
  • MODA (formerly ODS)
  • PacificSource
  • Providence
  • United Healthcare/Optum Health
  • Motor vehicle insurance
  • Worker’s compensation insurance
  • And many others…

Providence, Moda, and Blue Cross Blue Shield(Regence) customers:

Many plans under these carriers provide chiropractic care, but there are nuances about these carriers that you as a patient need to be aware of. Chiropractic care encompasses many different techniques and modalities. We at Milwaukie Spine and Sport, LLC use a variety of them to deliver the highest quality and most effective care possible. Many of these carriers plans however choose to classify some of the treatments that we do as Physical therapy. These treatments fall into the scope of practice of both chiropractors and physical therapists but are covered under different benefits under your plan. For example, if we adjust a patient and also do rehabilitative exercise with them, the adjustment would be covered under your chiropractic benefit with a $20 co-pay, but the rehabilitative exercise would be covered under a separate benefit as physical therapy as say 20% co-insurance. In this instance, you would owe $20 for your company and 20% of the physical therapy charges as opposed to just $20. This can add up quickly, especially if you have a deductible that applies to either benefit. We will always try to accurately quote your benefits but due to the highly complex nature of insurance benefits, accuracy cannot be guaranteed.

If you are Uninsured or Under-insured

Unfortunately insurance regulations prevent us from directly offering a cash discount however we do participate in a low cost discount card who we have a low contracted rate through.We participate in the Preferred Chiropractic Doctor discount card program.
If you are uninsured or under insured this discount card is available to you for a $37 annual fee.  We do not receive any kickbacks or profit from your membership.
Our low contracted rate with Preferred Chiropractic Doctor helps to make care affordable. You can sign up in our office or online. Our staff is happy to answer any questions you may have regarding this program.

We are NOT in network and CANNOT ACCEPT the following insurances:

Medicare

Medicaid

Oregon Health Plan

First Choice Health

And Some Others…


Medicare, Medicaid, Oregon Health Plan and Tricare

Milwaukie Spine and Sport,LLC cannot furnish Medicare, Medicaid, Oregon health plan or tri-care beneficiaries with chiropractic services at our facility.  Unfortunately the laws and regulations regarding these beneficiaries prevent us from doing so even when a beneficiary has a would prefer to pay out of pocket.  Medicare prevents us from billing them, billing you or providing service to you as a non-enrolled provider.  However, massage is a non-covered service and is still available to you through our office.

We investigated the process to become an enrolled provider to offer care to these beneficiaries but due to the increased record keeping requirements, additional electronic health record software costs, and increased training costs we are unable to enroll at this time.

In addition, Medicare views chiropractors as practitioners only, not doctors. As a result, the only chiropractic services covered under medicare are adjustments.  We cannot legally treat someone without at least performing an exam and history.  We practice a diversified technique at our clinic integrating therapeutic modalities, exercises and rehab with chiropractic. We feel that we cannot provide high quality, effective service to our patients if we are limited only to adjusting.  It is equivalent to being given a tool chest full of tools and then being told you are only allowed to use the hammer. This also factored into our decision not to pursue enrollment with medicare.

While we would normally contract privately when a patient is out of network, we are legally bound to refuse care to medicare beneficiaries due to the laws and our enrollment status.  We apologize for any inconvenience that this may cause you.


Payment Methods

We accept Many different payment methods!

visa-logos

We also accept Cash and Personal Checks!

We are happy to provide you with an itemized statement for HSA/FSA reimbursement.