[Denbal82]

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[blueash]

Originally Posted by Denbal82

I just went to Legacy Chirpopractic Care yesterday and I felt I got ripped off for being a new patient.

I needed to see a doctor ASAP and they had a opening opposed to the others I had called for an appointment. I did call my healthcare insurance prior to make sure Legacy Chiropractic Care was in my network - they were.

At the counter they told me I had to pay a "new Patient Fee" of $119. I thought that was ridiculous but I was in needed relief. They also told me that most insurance companies will pay for that charge. Thats BS ! as I found out later. My healthcare insurance also said "thats not right" after talking with them after my appointment. I felt they should have told me that over the phone when I made my appointment instead of putting me on the spot at the counter.

I later checked around and found out that other chiropractic care facilities do not charge a new patient fee. I felt like I got totally ripped off.

If you are a new patient, I would AVOID Legacy Chiropractic Care on Laurel Manor Dr.

If Legacy is going to bill your insurance company for your care, they will be using standard CPT codes. There is a code for new patient visits and a code for established patient visits. The new patient code has a higher allowable and reimbursement to cover for the additional work of setting up your chart, introducing you to the office expectations etc.

When you get your EOB, explanation of benefits, for the visit, look at what code(s) were used. If a new patient code was used you were double billed and I would loudly complain to the insurance company about fraudulent coding as they have already been paid extra for your newness. I would also insist that Legacy refund your $119. You paid it with the expectation that your insurance company would refund you.

Now, I've never heard of an insurance company refunding to a patient for a covered service when the doctor participates and will be paid directly for the rest of the visit charge. If the charge were legitimate, then Legacy should include it in the claim they submit to your insurance and be paid the allowable by your insurance [after applicable copay etc] The fact that they insisted you pay and hope you'll get it back strikes me as proof they didn't expect the insurance to pay that charge.

Almost all insurance contracts with doctors include a paragraph that the patient is not responsible for non covered services unless you agree to that service. As you agreed to pay the 119 I don't think that prohibition would apply here.

Lastly, you apparently thought you had a chiropractic emergency. Was it worth 119 to get treatment? Did you get the relief you wanted?

[DARFAP]

You should feel blessed that they got you in when no one else could.

[golfing eagles]

Originally Posted by blueash

If Legacy is going to bill your insurance company for your care, they will be using standard CPT codes. There is a code for new patient visits and a code for established patient visits. The new patient code has a higher allowable and reimbursement to cover for the additional work of setting up your chart, introducing you to the office expectations etc.

When you get your EOB, explanation of benefits, for the visit, look at what code(s) were used. If a new patient code was used you were double billed and I would loudly complain to the insurance company about fraudulent coding as they have already been paid extra for your newness. I would also insist that Legacy refund your $119. You paid it with the expectation that your insurance company would refund you.

Now, I've never heard of an insurance company refunding to a patient for a covered service when the doctor participates and will be paid directly for the rest of the visit charge. If the charge were legitimate, then Legacy should include it in the claim they submit to your insurance and be paid the allowable by your insurance [after applicable copay etc] The fact that they insisted you pay and hope you'll get it back strikes me as proof they didn't expect the insurance to pay that charge.

Almost all insurance contracts with doctors include a paragraph that the patient is not responsible for non covered services unless you agree to that service. As you agreed to pay the 119 I don't think that prohibition would apply here.

Lastly, you apparently thought you had a chiropractic emergency. Was it worth 119 to get treatment? Did you get the relief you wanted?

All true. Look at the EOB. If the CPT code was higher than 99203 they will have a hard time providing the appropriate documentation.

But "chiropractic emergency"? Isn't that an oxymoron?

[retiredguy123]

Only getting ripped off $119 by a chiropractor sounds like a bargain to me.

[golfing eagles]

Originally Posted by retiredguy123

Only getting ripped off $119 by a chiropractor sounds like a bargain to me.

Really???? Then you don't want to know my opinion of what "chiropractic treatment" is worth.

[retiredguy123]

Is it possible that the "new patient fee" had nothing to do with any treatment, and it was an administration fee?

[retiredguy123]

Originally Posted by golfing eagles

Really???? Then you don't want to know my opinion of what "chiropractic treatment" is worth.

You may have misunderstood my post.

[golfing eagles]

Originally Posted by retiredguy123

You may have misunderstood my post.

aha

[Cybersprings]

Legacy Chiropractic has the best chiropractors I have ever been to in my life. I always thought it was hippie magic kind of stuff in the past, and have had some chiropractors that I think ripped me off in the past. But I think they are amazing. When my back goes out and I look like a pretzel when I try to walk, they get me back in good health in very quick order. I don't know about the bill, the reason, what insurance will cover or not, but I will shout their praise any time I get the chance.

[JMintzer]

Originally Posted by golfing eagles

Really???? Then you don't want to know my opinion of what "chiropractic treatment" is worth.

I think he's implying that they were lucky that they were "only" ripped off for $119 as most Chiropractors will rip you off for much more...

[JMintzer]

All that said, if their "new patient" office visit is $119, that's certainly within the average of what many insurance companies pay for said visit (CPT 99203...)

But if they charged an "extra" $119 fee, in addition to charging your insurance company the 99203 "new patient visit", yes you were financially ripped off...

I'll leave it to the care recipients to determine whether or not Chiropractic Care in general is or is not a rip off....

[Babubhat]

Only if they spent substantial additional time evaluating your condition. If a crunch and go would not be happy.

Clermont has a superior chiropractor but not inexpensive. I have been through a dozen and he is the only one to provide significant relief long term. You can see the treatment in advance

https://youtu.be/D2ZEzkq9GXc

[Denbal82]

Thanks for responding. It was not an emergency. I just didn't have the time to walk out and find another doctor. I thought (maybe) that it would be covered by what they said. In any event, Legacy told me they would credit me for my extra fee. That was very nice of them.

[Denbal82]

thanks for your input. Legacy informed me they would credit me the $119 after my post on the TOTV.