The West Hartford Chiropractor to see - Chiropractor West Hartford

OFFICE POLICIES

Appointments
First Visit Preparation
Telephone Message System
Cellular Phones
Urgent Care
Snow Policy
Fee Schedule
Payment of Services
Third Party Payer Policies
HIPAA Notification

Appointments

Appointments may be made at the office and on the telephone. New patient initial appointments will require thirty to sixty minutes to address health history, current complaint and provide the appropriate examination for the condition. New patient health history forms are required. These forms may be completed ahead of the appointment to save some time. If unable to complete the forms before the appointment, please arrive ten to fifteen minutes early to do so. Treatment may or may not be provided depending upon the circumstances involved. Established patients with new conditions may require extra time to address any changes in health status since last seen, address the current complaint and provide the appropriate examination for the condition. Certain case history forms may be required, depending on the type and cause of the condition. These forms may be completed ahead of the appointment to save some time. If unable to complete the forms before the appointment, please arrive ten to fifteen minutes early. Treatment may or may not be provided depending upon the circumstances involved. Established patients receiving care on a regular basis may require five to twenty minute appointments depending upon their condition.

Appointments may be canceled with 24 hour notice. Exceptions can be made for illness, family emergencies and inclement weather. A charge will be made for missed appointments.

First Visit Preparation

Prior to reporting to the office you may need to complete a few items:

1. Medical records – please obtain any medical records (physician reports or records, x-rays, MRI’s, CAT Scans, Bone Density Scans, blood and/or urine tests, etc.) to provide upon entry.
2. Referrals – please obtain any referrals from a primary care physician or any other doctor as required by your health insurance company. Please send the referral form or script ahead of time or bring it on your first visit.
3. Injury Report – If your condition is related to a school athletic injury or condition, motor vehicle collision, personal injury on another’s property or work related, you will need to report the injury to the appropriate authorities.

   -School athletic injuries: report to the athletic director and school’s athletic insurance company.

   -Motor Vehicle Collision: report to your insurance carrier and your attorney if necessary.

   -Personal Injury: report to the property owner and your attorney if necessary.

   -Work injury: report to your supervisor, company owner, workers’ compensation insurance company and your attorney if necessary.

4. Methods of Payment – We accept many insurance plans, self pay and attorney liens when necessary.

   -Insurance plans: please provide us with your insurance plan information

   -Self pay: we accept cash, checks and credit cards

   -Attorney liens: accepted under certain circumstances when there are no other methods of payment and there is a firm case against another responsible party. Please notify your attorney to provide a Letter of Representation and Lien for your first visit.

On your first visit or returning after a prolonged absence or reporting after an accident (auto, work, personal) you will be asked to complete a comprehensive or brief health history, including past health problems, diet, exercise, occupation, and other information of importance such as an accident questionnaire if necessary. If you wish, you may obtain the appropriate paperwork from this web site. Please locate the paperwork for your situation, complete and return it to the office by mail or in person.

Upon entry, a case history will be conducted between you and your doctor. Be prepared to provide us with information that may help us help you. After this, an examination of your vital signs, musculoskeletal system, nervous system and/or organ systems may be undertaken. Special testing such as x-ray and laboratory work may also be utilized to determine your state of health.

Based upon your examination findings, a diagnosis will be made with the appropriateness of chiropractic treatment determined. Chiropractic care includes physical treatments such as adjustments, electric muscle stimulation, ultrasound, moist heat, ice, massage, exercise, sound and light therapy; biochemical treatments such as nutritional/dietary counseling, nutrient/botanical/herbal prescription and counseling about the prevention of disease, ergonomics, methods for living a healthy lifestyle, and encouragement for a positive mental attitude.

If treatment by other providers is necessary, whether entirely or as a compliment to chiropractic treatment, then a referral will be provided. You may not receive an adjustment at every appointment. The treatment you receive will be designed specifically for you - based on your symptoms and examination findings.

Your progress under chiropractic care will be carefully monitored. Your subjective improvement (the way you feel) as well as the objective findings (tests utilized by your doctor) will be noted, and your treatment plan may be modified to meet your changing condition. Communication between your doctor and other health care providers will be encouraged for your benefit.

Telephone System

From time to time during the working day, we may not be able to answer a call. Please leave a message with your name and phone number at the reception voice mail box and we will return your call as quickly as possible. Please be aware that throughout weekends and holidays, the doctor will check the machine for messages. Be sure to leave your name, phone number and a brief message at the reception voice mail box in order to provide you with prompt attention.

Cellular Phones

For the comfort of our patients and most especially for the comfort and focus of your own care, please turn off all cellular phones while in the office.

Urgent Care

For urgent care, we will schedule you as soon as possible. Please understand that those previously scheduled will have their appointments honored at the correct time. Please be patient as we will see you at the earliest opportunity.

Snow Policy

We make our best effort to get to the office through rain, sleet and snow to provide for your needs. But if safety conditions worry you, please call and let us know you will not make your appointment. We would like to know that you are safe! Sometimes even we cannot make it in. We will leave a message on the answering machine if the office is closed due to inclement weather.

Fee Schedule

* Adjunctive therapy includes modalities such as electric stimulation, ultra sound, stretching, heat, cold.
** Soft tissue treatment provided by the doctor.

Payment of Services

Fees due to our office are the responsibility of our patients. Many services provided will be paid by a third party such as general health insurer, auto insurance or workers’ compensation. With all third party systems of payment, the contracts are between you and the third party and in some cases between our office and the third party. Any service which the third party deems as uncovered is entirely your responsibility and may include the deductible, co-insurance, co-payment and uncovered services (massage therapy). Missed appointments will be charged to you unless 24 hours notice is given. We participate with many major health insurance plans.

Prompt Payment Plan

The “Prompt Payment Plan” is a discounted fee for services rendered when payment is received on the same day of service. This helps reduce the paperwork of submitting claims to a third party, tracing unpaid claims and billing patients. This program is applicable to anyone with or without insurance and receiving care in this office under the following circumstances:

1. We must not be a participating provider of your insurance company (insurer).
2. Payment must be received on the same day of service.
3. If applicable, we mail the insurance claim to you. You may submit the claim to your insurer.
4. We will not accept the assignment (reimbursement sent to our office) from the insurer.
5. All correspondence with the insurance company will be your responsibility.

* This program does not apply to managed care authorized visits.

Third Party Payer Policies

General Health Conditions

Conditions related to your general health care may be paid by your health insurance carrier or yourself. With health insurance plans, please keep in mind that coverage depends upon the contract signed by your self, the employer sponsor, government agency (Husky, Medicaid, Medicare) and/or the contract signed by this office. Many plans are different and must be reviewed by you and this office to assure a complete understanding of coverage and limitations. Please keep in mind that insurance plans do not determine the need for care and should not be solely depended upon to decide if you are to pursue care in this office. The decision to pursue care is ultimately your responsibility given your understanding of the type of care we provide. Balance from deductibles, co-payments and uncovered services are expected on the day of service. Durable supplies (braces, pillows, supports, exercise equipment) and non-durable supplies (vitamins, creams) are not covered by insurance. We accept cash, check and credit card.

Participating Health Plan List (partial list)*

*Participation status is subject to change without notice. Please confirm with our front office for participation status with your plan.

Motor Vehicle Collision (Accident) Conditions

For conditions related to motor vehicle collisions where you are the driver, passenger or a pedestrian, services may be paid by your automobile insurance carrier, the drivers automobile policy, your health insurance, yourself or upon settlement of a claim against a negligent party. In any event, the following steps must be taken:

1. Obtain the declarations page of your auto insurance policy and call your insurance agent or insurance company directly to clarify the provisions of your plan. You will need Medical Expense Benefits (MEB’s) to assure coverage. If you do not have MEB’s then you must obtain a letter from the insurer stating this fact as soon as possible.
2. Review your insurance policy and present your policy to the office. If you do not have Medical Insurance Benefits, you will need to submit your claims to your health insurance carrier. In order to do this you will need a note from your Auto Insurance carrier stating that you do not have Medical Expense Benefits. Also, your health insurance benefits must be verified by this office and you. All provisions of your health plan must be followed. (See above - General Health Conditions)
3. Notify our staff how you wish to pay for your care when there is partial or no automobile or health insurance coverage. We accept cash, check and credit card.
4. Notify your attorney that you are under care in this office. We will need a letter of representation to keep your attorney updated on the status of your condition. If you do not have MEB’s or health insurance to cover your costs then we may accept a lien on your case only for services related to treatment. It is our policy that the costs for administrative services, supplies and equipment are paid on the same day of service.

Medical Expense Benefits may be purchased on your auto insurance policy even if only offered as an option. Many believe their health insurance plan will cover the expenses for a motor vehicle related injury. Many also believe that their health insurance will have an adequate number of providers with the expertise to handle collision related injuries. This is not the case since most plans (all managed care plans) limit your freedom to select the provider and discipline of care you believe or have found to be best for you. In order to maintain some sense of freedom in your MVC related health care, remember to purchase the Medical Expense Benefits.

Personal Injury

For conditions related to personal injury such as slipping and falling on public or private property services may be paid by the liability carrier, your health insurance or yourself. In any event the following steps must be taken.

1. Notify our staff how you wish to pay for your care. We accept cash, check and credit card.
2. Bring in your health insurance policy for verification of benefits. (See above - General Health Conditions)
3. Obtain the liability insurance policy information from the owner of the property where your injury occurred.

If you have an attorney, notify him/her that you are seeking care in this office and that we will need a letter of representation to keep them updated on the status of your condition.

If you do not have health insurance to cover the costs for care and would like us to wait for your case to be settled and accept a lien on your case, then be advised that it is our policy to accept a lien letter only for services related to treatment. It is our policy that the costs for administrative services and supplies and equipment are paid during the course of care.

Workers’ Compensation

For conditions related to work injuries, you must report your injury to your supervisor and your case must be accepted by your employer. Your employer may send you to a doctor in their managed care network. You are required to visit this doctor for the initial examination. After this visit, you may choose to visit any other doctor within the employer’s workers’ compensation managed care plan. If there are no doctors of a particular discipline or specialty (i.e. chiropractic) in the employer’s managed care plan, then you may choose any doctor licensed in the State for that particular discipline or specialty. This means the panel is open to any doctor of the particular discipline or specialty. You should choose which doctor you want to care for your condition as soon as possible. Your employer must provide you with a complete list of providers on the plan. Be sure to ask for the complete provider list as well as the name address and telephone number of the workers’ compensation insurance carrier. If your employer contests your claim, then you must submit your claim to your health insurance carrier with a letter from the workers’compensation carrier denying the work injury. Patient balances from deductibles, co-payments and uncovered services are expected on the day of service. Durable supplies (braces, pillows, supports, exercise equipment) and non-durable supplies (vitamins, creams) may not covered by workers’compensation insurance. We accept cash, check and credit card.

Participating Workers’ Compensation Plan List (partial list)*

*Participation status is subject to change without notice. Please confirm with our front office for participation status with your plan.

For specific information about workers’ compensation and your rights access this information from 1, 2 or 3:

1. http://www.ct.gov (select: Government / State Government Web Sites / Executive Branch / Workers’ Compensation Commission (under Agencies header)
2. http://wcc.state.us/
3. http://wcc.state.ct.us/gen-info/if-injured/preface.htm

HIPPA Notification

Although Westside Chiropractic LLC has always worked to respect the privacy of our patients, recently enacted Federal law (HIPAA) requires that we adhere to new guidelines in the handling of your data. All of our employees have read and signed our office policy regarding their role in adhering to HIPAA requirements.

Patients have the following rights regarding their records:

1. The patient may request restrictions on the uses and disclosures of maintained data.
    
2. The patient may request an accounting of all disclosures of records.
    
3. The patient may review their records and offer an amendment to them.
    
4. The patient may request copies of their records (subject to copy fees).

Data maintained in our office files

Demographic data includes the patient’s name, address, phone numbers, birth date, social security number, employer or school, other physicians seen, current and previous medical conditions and other general health information.

Clinical data includes dates treated, conditions treated and information recorded by the physician and therapist regarding your treatment and any general health situations deemed to be applicable.

Insurance data includes the patient’s and the subscriber’s insurance company, group identifier, personal identifier, date of birth, social security number, and employer.

Data maintained in our computer system

Demographic data includes the patient’s name, address, phone numbers, birth date, social security number and employer.

Clinical data includes dates treated, services performed by the doctor and staff, the charges for these services and diagnosis (the reasons you are treated).

Insurance data includes both the patient’s and the subscriber’s insurance company, group identifier, personal identifier, date of birth, social security number, and employer.

*   *   *   *   *   *   *
 
Westside Chiropractic LLC may need to use the information contained in our systems for the following reasons:

1. To communicate with other doctors, hospitals and clinicians who may be involved with your health care.  Your physician will notify you when one of Westside Chiropractics’ doctors deems this necessary.
    
2. It may be necessary for our staff to contact you regarding your appointments.  Our office will only leave a message (stating the reason for our call and asking you to contact our office) on machines/mailboxes which specifically state your name as the owner.  Our office will only leave a message (stating no reason but asking you to contact our office) with a co-worker or family member.
    
3. To bill an insurance carrier supplying coverage for your treatments at Westside Chiropractic LLC.
   
   In order to bill your insurance, it is necessary for Westside Chiropractic to complete all applicable fields on a form HCFA-1500 (attached).  If you are being treated for a work related injury, we attach the doctors’ notes from that day.  If you are being treated for a motor vehicle or other accident related injury, we attach the doctors’ notes from that day.
   
   Some insurance carriers will accept billing information electronically.  This eliminates the need for form HCFA-1500.  The information sent to your insurance carrier electronically consists of the same data on form HCFA-1500.  Our office utilizes an outside billing service, Transaction Methods, Inc., to submit our electronic bills to your insurance carrier.  Transaction Methods, Inc. has signed an agreement with Westside Chiropractic LLC to adhere to all HIPAA standards.
   
   Your permission for Westside Chiropractic LLC to bill your insurance is part of the intake forms you have signed during your first visit to our office.
4. Westside Chiropractic LLC utilizes outside collection services for assistance in resolving unpaid bills.  This requires that we supply your demographic data, the unpaid services which were performed, the dates on which the unpaid services were performed and the unpaid charges.  The diagnosis (reason for treatment) is not disclosed.
5. To communicate with family members and close friends who may have an interest in your care.  In these cases, you must specifically allow Westside Chiropractic LLC to communicate with another person.
6. To communicate with third parties who may have an interest in your care.  This may include your attorney, other parties to legal actions involving your care or other parties designated by you.  In each of these cases, you must specifically allow Westside Chiropractic LLC to communicate with the third party.
7. As required by law, we may disclose your health data to law enforcement agencies.
8. As required by law, we may disclose your health data to public health agencies.

Further information regarding our specific policies dealing with patient privacy may be directed to your doctor or the office manager at (860) 523-5833.