Question
In March I went to see a chiropractor, I had extreme pain in my neck and lower back. I already had X-rays with me from a previous Chiropractor I had seen. After speaking with the Dr. he agreed to help me, but I was told that unfortunately my insurance did not cover Chiropractic care. I would need to pay $40 dollars a visit and the visits would be 3x a week for 2months. Then 2x a week for 2 months, 1x a week for 2 months. Ultimately getting me down to were I would get to 1 visit a month. When I couldn't pay that much money a week, he came up with a solution that would help me. He had me sign up for a CareCredit credit card.

I really didn't want to open up a credit card, but he told me that this would cover me for a whole year. I would also need custom orthopedic insoles for my shoes and this would help speed the recovery process. The total was going to be $2000,but he would waive $200 for the X-ray since I brought mine in. He was also going to waive the consultation. So now the total cost would be $1600.00, but I didn't get total approval from CareCredit for the whole thing. I was only approved for $1,400.00, which the office charged immediately. The Dr. said I could pay a little at a time to pay the remaining $200 balance; which I did.

Just after 5 months, he tells me that today is my (35th) visit and my "treatment" plan has ended. So here on out I would have to pay $40 dollars a visit to maintain my " preventative maintenance plan". When I asked what happened about a year's worth of treatment. He stated that my insurance only covers 35 visits, which took me back. How is this possible??? You told me, my insurance didn't cover any chiropractic care. I stated "Oh " Ok let me check that out and I get back to you. So I didn't say another word and left the office.

I contacted the insurance company about what was going on and was informed that my co-pay to his office should have only been $25 dollars a visit. I was also only billed for 17 office visits. I was informed by the claim rep on the phone to bring my receipts and my "EOB"statements  over to his office. Claim Rep-Just give him the benefit of doubt,and see were he made a mistake. So I did just that, and when the Dr. saw all the papers I brought with me . He took me aside and explained that he made a mistake and would take care of this. The next statement floored me, he said all of my stretching exercises performed in the office would be billed.  I just looked at him, and said whatever and left.

In the next 2 weeks I found out the chiropractor billed for a total of 42 visits. His office even went back and re-billed for the past 5 months for different treatment he said he performed at his office. So now I see a total of 84 total charges. What do I do??? I feel so embarrassed, that I was taken advantage of this way.

Any information you could provide me I would greatly appreciate it.
Thank you so much for your time in reading this.

Answer
Hi Leonard,

Don't feel embarrassed.  You didn't know what to expect.   Sadly, there is no ready information to the public about how to find a good chiropractor and what constitutes good care.    We do have a guideline, the CCGPP (Chiropractic Clinical Guidelines and Practice Parameters), and your chiro' failed to abide by it.     How can he know in advance that you needed all those visits?   What if you felt completely well after two visits?    Also, if he is a contracted provider with your insurance plan, then he must abide by that company's rules.    If he did not perform the treatment, then he really cannot bill for it - that's illegal.   If you had insurance coverage, your cost should be $25 per visit times the number of visits.    If you did exercises, and he also adjusted your spine, then yes, he would re-bill for the exercises.   He should also have very clear, legible records to document your visits.   You need to get a copy of your records, and his office must provide them.    You can also contact your state's licensing board to if you feel that you were taken advantage of.    My greatest issue with all of this is the pre-fabricated plan of visits without knowing how a patient will respond to care.    In other words, you should be periodically examined every few weeks and, if you are feeling better should be discharged or tapered-off from care.   35 visits in five months is excessive for most everyone.

'Hope this helps.

Dr. G