Insurance and Billing

Our services are covered by most insurance companies. Unfortunately our specialty, Osteopathic Manipulative Treatment, has been subjected to nationwide audits and unsubstantiated refunds for services. After being subjected to this multiple times, we made the very difficult choice to phase out of in-house insurance billing. At this time, we are in-network with Samaritan Choice, Samaritan Commercial, Regence Blue Cross Blue Shield, and Providence. We are out-of-network with all other health insurance companies, including Medicare and Medicaid.

If you utilize an insurance company we do NOT bill, we will: 1) collect payment from you directly on the date of service and you may bill your insurance company for reimbursement. We will provide all the documentation and guide you through the process. (See below for steps regarding reimbursement) OR 2) We may be able to do out-of-network billing. You may talk with a staff member to see if this is an option for you.

The amount that is reimbursed to each patient for our services will vary based on the individual policies and coverage. The out-of-pocket cost to you is generally a little higher for an out-of-network provider; however in some cases (after deductibles) the out-of-pocket is lower. We recommend you call your insurance company and ask them. We have composed a form to help you get the information you need from your insurance company, see link below.

Download form as: PDF

Patient Insurance Billing

Most insurance companies are very quick to reimburse members for visits the member pays for out-of-pocket. There may even be the ability to fax or email your reimbursement claim for faster response. Many insurance companies have online user-friendly question and answer websites. If convenient, you could try finding the information there.

Here are the steps to get reimbursed from your insurance company (in no particular order):

  • Some insurance companies have a “reimbursement” form; you should inquire about their steps for reimbursement ahead of time. Often just sending these items will work:
  • A sales receipt that states you paid in full and need to be reimbursed directly (which Crossroads Premiere Health Care will provide on the day of your appointment.)
  • A form with the date of service, procedure and diagnosis (es) code(s) for the services you received (which you will also receive on the day of your appointment.)
  • We have an Opt-Out Letter for Medicare Recipients, which may be necessary – please ask for a copy.
  • Your personal information including name, date of birth, age, address, phone number, insurance ID number, group number, and a Prior Authorization number if one has been issued.
  • Submit to the address specified by your insurance company.

Note: Until you have actually billed and received a check from your insurance company, you will not know for certain how much you will be reimbursed!

Medicare Patients

Unfortunately we are a non-preferred provider with Medicare, which means our services are not covered and Medicare will not allow you to bill for reimbursement. You would have to pay for our services entirely out-of-pocket. Further, Medicare requires us to have you sign a waiver that you understand this policy. However, some supplemental policies may pay for Medicare’s non-covered items. You should call and ask.

In Closing…

If you have any additional questions or need assistance, feel free to contact Bridgett in our billing office at 541-207-3773 or at