We accept Insurance, Cash, Personal Checks, Visa, MasterCard and American Express as well as Debit Cards and HSA Cards. Helping you to navigate Payment & Insurance is an important part of your experience at Blue Heron Chiropractic.
Blue Heron Chiropractic on NE Broadway can bill most insurance plans with chiropractic coverage, including MCOs,PPOs and HMO plans. We collect your co-pay or co-insurance percentage at the time of services and bill insurance. Please note, we are not set up to bill Medicare or Medicare Advantage patients at this time. Also, we are unable to accept cash or self-pay from Medicare or Medicare Advantage.
We can bill all Motor Vehicle and Worker’s Compensation cases. No referral is required for Motor Vehicle or Worker’s Compensation.
Self-Pay discounted Fee Schedule
For Self-Pay, we offer a state-approved Discount Medical Payment Option (DMPO). You can elect to save 50% to 30% as “Self Pay” at time of service. Becoming a member of the DMPO group and paying at the time of service gives you access to a special fee schedule through the DMPO. This schedule essentially provides a 50% discount on the first visit, and 30% on subsequent visits for selected services. This makes the fees at Blue Heron Clinic competitive and affordable for the services you receive.
Fees are based on the Oregon approved fees or appropriate insurance rules. DMPO discounts are calculated based on services provided. If you elect optional special services beyond the basic chiropractic services, certain charges will apply but are still within a DMPO discount schedule. Diagnostics can also increase the base amount, but the 30% DMPO fee schedule applies to this treatment as well. As of January 2023, under the DMPO a basic first “intake” session (50 – 55 mins) can typically be expected to work out to $130.28, and the next up to 3 basic sessions (30 mins) can typically be about $65.28 – depending on what care is requested or what is required. After that, a basic 30 min session can be $55.28 unless special services, re-examination or diagnositics are needed. Further discounts may be available for recurrent care on a treatment plan if you reschedule on the same day within one to three weeks. Urgent Care, Major Trauma or medical-legal sessions or complex sessions should probably be expected to add up to more than this. These fees are still competitive, and Doctor Sibilla is an advanced practice provider.
DMPO Discounts as a Supplement to Insurance
Our DMPO discount option can also be used as a supplement to insurance. For example, where and when insurance does not pay for certain services. For example, if your Blue Cross policy covers adjustments but does not cover massage therapy, the DMPO discount can be applied to those services.
If information is made available prior to your appointment, we will attempt to verify coverage for you. It is your responsibility, however, to know your insurance benefits. When contacting us, please have your insurance info available. It’s important to know the specific “name” of your policy, like “Oregon Select Choice”, as well as the “brand”, like “Providence”. We always try to get this info up front, to create clarity and improve satisfaction.
The following is a list of some of the carriers we support. Many carrier names are included under others in “umbrella” fashion.
If you do not see your carrier in the list below, contact the front desk at (503) 280-9759.
LIST OF CARRIERS
THIS FOLLOWING IS NOT THE ONLY LIST OF CARRIERS WE BILL. THIS LIST IS CONSTANTLY UPDATED. PLEASE CALL AND ASK. When you call, please know if your coverage includes chiropractic. Remember, as above, the “name” of the plan is very important.
|Kaiser Permanente||One Health Plan||Allstate|
|Complementary Healthcare Plans (CHP Networks)||Cigna / Healthways||USAA|
|Blue Cross Blue Shield (BCBS)||Aetna||Safeco|
|Providence Health plan||Mega Life & Health||Nationwide|
|HealthNet / ASH||Wausau||Farmers|
|Blue Cross/Blue Shield HMO PPO Regence Anthem||Liberty Northwest||Encompass|
|Health Care Mgt Admin||The Guardian||American Family|
|School District #||Associated Administrators||State Farm|
|American Specialty Health (ASH) Networks||Republic Indemnity||Country Companies|
|ACN Group / Optum||Oregon Worker’s Comp||Allied|
Please have your current insurance card available so we can copy it. If you call the Front Desk Administrator at (503) 280-9759, you can request that we can help you confirm your insurance. We will otherwise do this on or after your first visit, depending on the time of day and availability of the confirmations services. Please open all mail from your insurance company before your appointments.
When you call your insurance company to verify your benefits, you will hear the following, which we repeat for you here, because it is important. This is what they tell us, as well:
“Pre-authorization of benefits is not a guarantee of payment. Final determination on the claim is based on clinical necessity and will be made within specific time guidelines upon receipt and review of the supporting documentation.”