Please Note: A 3.95% surcharge is added to all Credit Card payments, except HSA and FSA.
Insurance Coverage for Chiropractic Care
I am an "in network" provider for most PPO Insurance, such as, Anthem, Cigna (not My.Cigna) Blue Cross/ Blue Shield, Blue Shield of CA, Federal Employees and Labor Union Insurance. I am "in network” for Optum, Veba, and many UMR and United Health Care. I do not accept any other HMO insurances or Aetna..
For Medicare coverage scroll down to the Medicare section below
You must confirm your insurance coverage at my clinic by calling Member Services on the back of your card. First ask if I am in network or out of network. You should confirm your deductible and co pay at that time as well. The other option is to pay cash fees, I will then bill your insurance and forward any insurance check to you.
Those of you with insurance who have not yet meet any remaining deductible will pay on per visit based on the below Cash Fee Schedule until any deductible has been proven to be met, after which agreed upon co-pays will be paid per visit.
(A deductible is a dollar amount of how much you must spend on covered medical expenses before your insurance will begin to pay part or all of your expenses. Thereafter, a co-pay is then usually required, either a dollar amount or a percentage of the cost. If you do not know what your deductible or co-pays are, or how much remains of your deductible, call Member Services on the back of your insurance card. Confirm whether I am in network or not and what the deductible is for chiropractic care at my office. Then confirm what your co pay is for chiropractic care. NOTE: Cash fees apply until deductible is known to have been met.) Please note that ultimately you, not your insurance company, are responsible for your bill. Therefore, I strongly advise you call Member Services if you have any doubts about your co-pays and deductibles,
Co pays and deductibles payments may be by cash, check or credit/debit cards. I will submit all insurance forms for you.
Fees for “alternative medicine”, holistic health care and nutritional analysis and recommendations are not covered by most insurance and are therefore paid for on a cash basis as shown below.
I do not accept PI Liens for New Patients. (I will consider PI liens for current and former patients on a case-by-case basis.)
I will consider Med Pay car insurance for personal injury on a case-by-case basis. A credit card will be kept on file until the coverage is verified through your claims adjuster.
I do not accept workers compensation cases unless referred by One Call Physical Therapy.
I do not accept Medical, Medicaid, Community Health or Covered California policies.
I am a Preferred Medicare Provider accepting those with Medicare Part A and B and those with secondary insurance payer Plans G, N and F.
I am also in network for UHC Medicare (such as AARP Advantage and UMR). However, some. UHC, UMR Medicare plans require a medical referral. You can call member services (Phone # on the back of your insurance card) or consult your annual Medicare Handbook to see if referral is required.
Important Note: Medicare plans only pay chiropractors for adjustments of the spine. They do not pay for initials exams or re-exams for which the cash fee schedule will apply. Medicare also does not reimburse chiropractors for extremity adjustments, physical therapy, acutherapy, dietary and supplement analysis, rehab exercise instruction, activities of daily living training. As such, all Medicare patients will have a co-pay / surcharge of $20 for routine office visits.
Cash Fee Schedule:
Those without insurance coverage for chiropractic, or who have not yet met their deductible, are paid for on a cash basis as presented below. (Children 12 and under and active military and their spouse and children up to 21 are eligible for my sliding scale fee shown below)
Cash fees are the same whether for chiropractic or nutritional holistic care is desired. Payments may be by cash, check or credit/debit cards.
New Patient Exams are $95: This fee usually covers all care, instructions and advice given, including adjustments and therapy on the initial visit. Supplementation and orthopedic supports IF recommended are paid for at the time of purchase. Lab testing is not routinely ordered but it is available when indicated or desired on a cash fee per test basis. I do not have X-Ray facilities. X-rays, which on occasion are needed, are usually referred to a Valley Radiology site nearest you.
Established Patient Re-exams are $75. Re-exams are needed for new injuries, marked exacerbations or patients who have not been seen in a long time and re-evaluation is needed. Treatment is included.
Routine 0ffice Visits are $55. This a usually a "per diem" fee meaning all services are included.
Sliding Scale Cash Fees
Reduced fees are for Minors (12 and under) and Active Military and their spouse and children up to 21.
New Patient Exam: $75: This fee usually covers all care, advice and instructions given, including adjustments and therapy on the initial visit. Supplementation and orthopedic supports IF recommended are paid for at the time of purchase. Lab testing is not routinely ordered but it is available when indicated or desired on a cash fee per test basis. I do not have X-Ray facilities. X-rays, which on occasion are needed, are usually referred to a Valley Radiology site nearest you
Established Patient Re-exam $55: Re-exams are needed for patients with new injuries, marked exacerbations or who have not been seen in a long time. Treatment is included.
Routine Office Visit: $45
Missed Appointment fee $20. If you are unable to keep an appointment my policy is that you kindly provide me with at least 24 hour notice to avoid our $20 fee.
IF you have any questions about the above call me at 1-760-500-6253.
Scheduling an Appointment
If you would like to make an appointment, please call me, "Dr. John" as I am known in Valley Center, at 1-760-500-6253. I schedule my patients in such a way that emergency care can usually be provided quickly. I am known for being on time with my appointments. But I can only be on time if you are! Please keep your appointments on time. 😊