Payment/Health Insurance

Q: Do you take health insurance?

A: Well Set is an out-of-network provider with all insurance companies. This means we accept all major plans (excluding Kaiser Permanente) if they include out-of-network benefits.

Q: What the heck does “out-of-network benefits” mean?

A: Providers of out-of-network benefits usually have their deductible separate from in-network benefits. This means that the out-of-network deductible must be met before your insurance will cover a specified percentage of each visit. For example, you might have a $500 out-of-network deductible that needs to be met before your insurance company starts to cover their portion. After this deductible is met, your insurance will cover their portion (for example, 75% of the visit) and you would be responsible for your co-insurance (which would be 25% in this hypothetical case).  Having “out-of-network benefits” is pretty similar to a co-pay situation for in-network providers. Every plan is individualized, just like the care we’ll provide for you.

Q: Why are you an out-of-network provider? That seems weird! Shouldn’t I just find a chiropractor who is in my network? Wouldn’t that be cheaper?

A: As specialists at Well Set (who have advanced certifications in what we do), we believe in the quality of care over the quantity of patients we see. This belief allows us to spend more time with every patient and to provide better, individualized patient care. To be in-network, providers have to agree to a lower reimbursement rate. With lower reimbursement rates, in-network providers are oftentimes forced to spend less time with patients, treat multiple patients at a time, and/or use cheaper, more passive modalities (heat/ice, electrical stimulation, ultrasound, etc.) to try to get you better, instead of treatments tailored to you. 

At Well Set, we prefer more of a one-on-one style of treatment where you have your provider’s full attention throughout your treatment. We prefer to spend extra time getting to know you and your body, helping to create an individualized, active plan of care. This preference results in fewer visits to get you back on track, which ultimately saves you money and time. 

 

 

Q: Can I pay out of pocket if I don’t have out-of-network benefits?

A: Absolutely! We offer killer time-of-service discounted rates for patients who invest in their own health and wellness. You can pay per visit, or purchase a package to save even more money in the long run. You can even use your HSA or FSA to purchase time-of-service visits and packages!

Q: What about Medicare and Medicaid/HMO plans?

A: We accept Medicare as a “non-participating provider.” This means that we will collect payment from patients covered by Medicare plans at the time of the service (i.e., during your visit) and submit a claim to Medicare on your behalf. Depending on your individual benefits, Medicare or your secondary insurance will then reimburse you a specified amount (according to your benefits). We do not currently accept Medicaid or HMO plans.

Q: I still don’t get it? This stuff is confusing!

A: We know it’s complicated. We’d be glad to help explain more or to help you check your insurance benefits prior to your first visit with us. Just give us a call at 720.739.0745 or shoot us an email at hello@wellsetdenver.com.

 

If this makes total sense...