Legacy Chiropractic Care Charges
 

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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?

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

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? :1rotfl::1rotfl::1rotfl:

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.

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

You may have misunderstood my post.

aha:bigbow:

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.

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...

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....

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

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.

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

They called it a new patient fee. I was told that they would credit me my $119 after I posted my post on the TOTV.

Well good. I have used Legacy many times over the years. Never at any point did they charge me this fee. Now I went to Compton Chiropractic a couple years ago and they wanted to charge me a new patient fee of over $200.00.

Then you don't have a clue what they can do, after multiple visits to primary MD and podiatrist for my plantar fasciitis and NO relief it was the chiropractor office that finally gave me treatments that actually worked...don't knock them..

I got ripped off for over 3x that much 2 years ago after initially just wanting to get an adjustment. So $119 would've been a bargain. But while I was there he suggested xrays and I was curious to see how my spine was with my little come and go pain tweaks. They turned out fine, but it was a $400 lesson to next time get any back x-rays from a participating ortho. Somehow I knew that, but what I could've done was question the total cost before the procedure. Hindsight = 20/20. Plus I used to work for medical insurance and like I said I should've known better. His cost estimate for $75 per adjustment session 2x a week is what I passed on.

History of chiropractic - Wikipedia Scary reading.

I’m pretty sure I have more than just a clue, having spent over 30 years cleaning up their disasters.

Too often there are ways that the system is abused. I call Shenanigans. Had one doctor that was getting paid each week from my insurance. I saw the doctor 1x a month. When I asked him about it, he said that he set aside 30 minutes each week to answer any questions I may have. The shenanigan (SP) that bothers me perhaps the most, was when I would get surgery for c I had in my thirties. I made sure that the surgeon was covered. I got huge bills for anesthesia . I said on my future surgeries I wanted to use a group that accepted my insurance. No can do. The hospital had an exclusive agreement with one group, a group that did not take insurance.

Why not a real Physical Therapist???

Because a physical therapist does not do what a chiropractor does.
And I don't think all major medical insurance plans would cover the care if it was not "real".

Thank God for that.

Yes. And thank God a dentist doesn't do what a surgeon does, and a optometrist doesn't do what a proctologist does, and.....

I think someone is just making assumptions about chiropractic and does't have a real clue about it.

Yeah, that must be it. I think I'll go out on a limb and suggest I know 10,000 times as much about medicine as you do. Just another "assumption":1rotfl::1rotfl::1rotfl:

I see. Maybe it's like this other person I knew who was a retired doctor intimidated by people who don't prescribe drugs after getting wined and dined by drug companies. Too bad chiropractic is not real medicine like prescribing Thalidomide to pregnant mothers.

And since it is wikipedia, there is clearly only objective information.

Legacy clinic
 

I called about an ad they had in the newspaper, and asked if that treatment was covered by medicare. She said yes 100%. So I went for 2 days and they charged me $150. I wasn't improved any, so I didn't ever go back.

Don’t know any of the chiropractors. But maybe the clue was that they had openings and the others did not?

No problem taking a swipe with no knowledge of the people. Nice.

Wow, your insight is amazing. You've got this whole practice of medicine nailed down---kickbacks, dinners, golf outings---physicians basically owned by drug companies and doing their bidding. Yep---how did you know???? And thalidomide is a great example---a drug banned by the FDA in 1962. How about leeches and bloodletting? they were used by doctors 300 years ago as well. Thank God we have chiropractors to heal the wounded and cure the sick. :1rotfl::1rotfl::1rotfl:

But seriously, the ignorance exhibited in those posts is astounding. Pharmaceutical reps can't even give out free pens.

But the best is citing "Wikipedia" as an objective source. Yep----if it's on the internet it must be true.

They start you out with the top guy and then pawn you down to some other guy. Way too expensive, I’d rather stand in shower, feel better.

Or maybe they had a last minute cancelation and the others did not. I love when people think they are mind readers.

Some people think chiro is voodoo. Others, like myself, have had years of relief from good chiropractors. The reality is that not all chiros are talented (someone had to graduate last in the class) but good ones are gold.

As far as billing, if they are IN-network, they can only bill for allowed procedures and only up to the maximum contracted amount. It's the system that has them charge more for initial visit vs periodic, and the system that has them take xrays and do a thorough evaluation lest they be sued for missing something.

Cute. Say it like it's a fact and say it arrogantly and I guess you think people will believe it.

But, from the NIH:

"Financial payments from the drug industry to US physicians are common. Payments may influence physicians' clinical decision-making and drug prescribing.

"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315858/#:~:text=Financial%20payments%20from%20the%20drug, decision%2Dmaking%20and%20drug%20prescribing.

So, try again on convincing everyone how knowledgable and virtuous you are and how ignorant I am.

The example of Thalidomide was old, just very easy and known by everyone in our age group. There are many examples of drugs prescribed by doctors that have since been taken off the market or limited due to the harm they caused.

And if you bothered to read my post, I said "Thank God" (paraphased) people stay in their own lane and do what they know. I never claimed that doctors are not hugely valuable. Just don't try to tear down other practictioners because you think you are so much better. You know what they call a medical student that graduates last in their class, right?

The level of hubris in your posts is also astounding.

Please see post #38 which followed yours, but let's play anyway

The NIH is clueless about what goes on in the real world, great for research, not so good on a daily basis, so i have no idea what they were babbling about. Could a few doctors be influenced by some illegal payments? I'm sure they're out there. But pretty rare.

Didn't claim that you were ignorant, just the content of some of your posts. I'm sure you're intelligent when it comes to subject matter you are familiar with, but medicine is clearly not it.

Oh, and do I merely think I am a better health care practitioner than a chiropractor? No, I know it. Not even close

Thalidomide?

That was last used when?

I'm surprised you didn't bring up the "Leeches" and "Blood Letting" lobbies...


Edit to add: Damn! I broke my own rule about posting before reading thru the thread... :o:o:o

""Financial payments from the drug industry to US physicians are common."

Wait, what? WHERE'S MY MONEY???

The most I ever got was donuts...:grumpy::grumpy::grumpy:

You got donuts????? Really?????

I'm pretty sure I've prescribed 10x as many drugs as you, just by the nature of our specialties, but I never got a donut. That sucks. I feel cheated!!! Maybe the NIH confiscated my donuts :1rotfl::1rotfl::1rotfl:

But I'm pretty sure if I could have caused some phocomelia with thalidomide they would have given me 2 donuts. And maybe a croissant for every case of gyn cancer from DES. But if I revive the treatment protocols of Theodoric of Yok, medieval barber, I might get a hamburger from Mcdonald's. NAH!:1rotfl::1rotfl::1rotfl: