Integrated Appointment Request Form
We know that understanding your insurance coverage can be confusing. When you make an appointment with us, we will ask you for your insurance information so that we may do a precheck to verify your coverage before your visit. You also may contact your insurance to understand your coverage for visits with our practice. Some plans may include physical therapy benefits but not chiropractic care or massage. Ask our helpful staff if you have any questions or concerns about treatment plan costs.
Notice of Availability of Good Faith Estimates
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises
Contact our offices by phone, fax, or email via our website contact page.
We also offer Self-Pay Rates for those without insurance.
- Chiro Eval & Treatment $100
- Chiro Treatment $48
- Chiro Treatment for Seniors (over age 65) $43
- PT Eval & Treatment $100
- PT Treatment $75
- PT Treatment for Seniors (over age 65) $70