Patient Compliance Letter 2022

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Patient Compliance Letter 2022

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Kelly Family Chiropractic
Dr. Janine D. Kelly
1762 Newbridge Road
Bellmore, NY 11710
(516) 409-0044

2022 Insurance rules and regulations: Below are the most recent enforcements that we must adhere to in order to avoid fines and penalties. Please initial next to your insurance.

**Please be sure to sign in upon arrival as proof to the insurance company.

We realize each case/condition is unique and we encourage you to speak with us about your care.

Please note: It is illegal for us to “waive” your co-payment.  By law: Failure to collect patients’ portion of the care (co-payment) is considered a violation of the Anti-kickback statute AND the false claims act.  The routine waiver of the patient responsibility can cause serious consequences.

Our Office believes in the value of wellness care for you and your family and have maintained a pricing structure that allows care for all budgets.
It is your responsibility to know your coverage and benefits.

  1. New Medicare deductible for 2022 is $215.00. As we receive the statements, we will check for any deductible monies due. If you have a secondary plan, we will collect your copay based on that statement.
  2. Requires exams every 30 days, but they do not make payment on this service. As we comply there will be a reduced fee of $30(Typical Exam fee $65-$200). All services except spinal manipulation are excluded. This includes electric stimulation, and ultrasound (which we provide as needed). Your secondary/supplemental insurance may or may not pick up these services. We will notify you of the fee, & you may choose or deny this service. (ABN form) Page 34 of the Medicare manual.
  3. Does not allow for Chiropractors to write scripts for any radiology service (X-Ray/MRI). You must see your Primary MD.
  1. Maintenance therapy is a noncovered benefit. This includes & is described as:
    1. minimal or no pain on multiple visits without improvement
    2. 1x per week or less often without a structured care plan and documentation with patient compliance. “Haphazard” care is not allowed.
  2. Insurance companies have the right to request your file and request reimbursement from the Chiropractor if these requirements are not met.
  3. They can also terminate YOUR coverage.
  1. Response to Chiropractic Treatment is within 4 weeks
    1. If no improvement is documented within 30 days despite modification of care, continuation of care is considered NOT medically necessary & not payable.

2. Chiropractic care in persons whose condition is neither regressing nor improving is considered NOT medically necessary. This also applies to MEDICARE.

  • Is offered to complement your care
  • Is open to the public
  • May not be part of your plan. In this circumstance, Maxem Medical will reduce their fee AS A COURTESY to $75/visit.
  • Maxem Medical, is an Independent Contractor within our office, and they will bill for services.

We appreciate your anticipated cooperation.  We look forward to helping you achieve your health goals.  Please feel free to speak with us about any concerns you may have.  Your health is important to us.

Thank you.

Dr. Janine D. Kelly, Leanne, Christina & Brittany