How Out-of-Network Insurance Works for Chiropractic and Physical Therapy

Short answer: out-of-network doesn't mean your insurance won't help. Many PPO and POS plans pay part of the cost of care from providers outside their network, usually after you meet an out-of-network deductible. We accept health insurance as an out-of-network provider, auto insurance claims, workers comp claims.

In-Network vs. Out-of-Network

An in-network provider has a contract with your insurance company that sets prices in advance. An out-of-network provider doesn't have that contract. Your plan may still cover the care, but usually at a different deductible and coinsurance level. HMO and EPO plans often cover little or no out-of-network care, so it's worth checking your plan type first.

Terms to Know

• Out-of-network deductible: what you pay before the plan starts sharing costs. It is often separate from your in-network deductible.
• Coinsurance: the percentage you pay after the deductible is met, for example 30% or 40%.
• Allowed amount: the amount your plan considers reasonable for a service. Reimbursement is based on that amount.
• Out-of-pocket maximum: the most you pay in a plan year. Out-of-network care may have its own maximum.
• Visit limits: some plans cap chiropractic or physical therapy visits each year.

Questions to Ask Your Insurance Company

1. Do I have out-of-network benefits for chiropractic care, physical therapy, massage therapy or acupuncture?
2. What is my out-of-network deductible, and how much have I met this year?
3. What coinsurance applies after the deductible?
4. Are there visit limits or prior-authorization requirements?
5. How are claims submitted, and how long does reimbursement take?

Our front-desk team can help you check your benefits and explain the process before your first visit, so there are no surprises.

Other Ways to Pay

• Auto insurance claims: after a car accident, your auto policy's medical payments coverage or the at-fault driver's insurer may pay. See car accident injury care.
• Workers' comp claims: for injuries on the job, with authorization from your treating physician or adjuster. See work injury care.
• HSA and FSA cards: chiropractic care and physical therapy are generally eligible medical expenses. Check with your plan administrator.
• Direct pay and membership: see pricing and our monthly membership.

Why Some Patients Choose an Out-of-Network Clinic

Out-of-network clinics aren't bound by an insurer's visit-length rules, so there is time to listen, examine you thoroughly and look for the real cause of your pain. That time is central to how we practice, especially for severe and chronic conditions.

Frequently Asked Questions

Does Allied Healthcare take my insurance?

We accept health insurance as an out-of-network provider, auto insurance claims, workers comp claims. Call (303) 465-6332 and our team will help you check your benefits.

Will out-of-network care cost more?

Sometimes, depending on your deductible and coinsurance. For many patients, a focused plan that resolves the problem costs less overall than months of care that doesn't.

Can I use my HSA or FSA?

Chiropractic care and physical therapy are generally eligible HSA and FSA expenses. Confirm with your plan administrator.

What if I don't have out-of-network benefits?

You can pay directly or use our monthly membership, and we'll explain costs before care starts.