Saum Chiropractic
Please use the following links to print and fill out our insurance coverage and patient health history forms. The forms are formatted in Adobe Acrobat, in order to view them you will need Adobe Acrobat Reader installed on your computer. If you do not have Adobe Acrobat Reader you can click here to download it FREE.
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GROUP OR INDIVIDUAL INSURANCE
We attempt to take out as much of the "insurance hassle" as
possible for you. We'll happily telephone your insurance company to verify
your coverage benefits. Please remember, however, that the benefits quoted
to us by your insurance company are not a guarantee of payment. We will
file your claim and await payment for 90 days. If your company pays the
benefits they quote to us, the only services you will be responsible
for are any non-covered services, deductibles or co-pays. If you have
any questions at all regarding you financial responsibilities at our
office, please do not hesitate to ask. Our insurance clerk has years
of experience and will be happy to assist you.
PATIENTS WITHOUT INSURANCE
An increasing number of patients do not have insurance, or have plans
with limited coverage, such as catastrophic policies. We realize that
no one wants to build up a large bill. Therefore, we have several plans
so those patients may receive complete care without undue financial
difficulty. Of course we are always happy to accept cash, your personal
check, MasterCard, Visa or Discover cards.
"ON THE JOB" INJURY (
If you are injured on the job: Under Mississippi law you are allowed to seek care from the doctor of your choice. You must first obtain authorization from your employer. If your employer refuses authorization you are still eligible to receive up to 15 visits or 30 days of care. In ether case, we must have the name and address of the insurance carrier to process the claim. If you do not provide this information, payment for services will be your responsibility. If WC ultimately decides not to pay for any portion of your care you are personally responsible for payment. (Contact the office for details)
PERSONAL INJURY OR AUTOMOBILE
ACCIDENTS
Please notify your auto insurance carrier of your visit to our office immediately. Notify our insurance department immediately if an attorney is representing you. Although you are ultimately responsible for your bill, we will wait for settlement of your claim for up to six months after your care is completed, if we have a guarantee of payment. This would be a signed lien from the insurance company or attorney or a credit care guarantee. Once the claim is settled or if you suspend or terminate care, any fees for services are due immediately.
MEDICARE
We do accept assignment from Medicare. The check is usually sent directly
to our office in payment of the services that Medicare will cover,
which for Chiropractors is ONLY manual manipulation of the spine. Medicare
pays 80% of the allowable fee once the deductible has been met. You
are required to pay the deductible and the remaining 20% as well as
any non-covered services. Our office completes and files the forms
for Medicare at no charge.
SECONDARY INSURANCE
Please inform us of any secondary insurance you may have. We will assist
you if you need help in filing.
