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 General Information
Since chiropractic has become accepted in the mainstream medical community as a beneficial alternative to traditional medicine, most insurance companies have also accepted it and therefore offer chiropractic benefits to their policy holders. Insurance companies are also acknowledging the benefits of acupuncture, therefore we are now seeing acupuncture benefits offered by many insurance companies as well. When you arrive at our clinic for your first appointment, we can take a copy of your insurance card and check your chiropractic or acupuncture benefits for you.
Many insurance companies belong to Managed Care Networks for which physicians then apply to become participating providers. In turn, a list of these providers are given to each policy holder. By using these participating providers, the policy holder is usually given a higher level of benefit which almost always results in a smaller out-of pocket cost. Use of non-participating providers usually results in a higher out-of-pocket expense for the policy holder but not always. This is why we take the time to call for each individual's personal chiropractic benefits. Regardless of Dr. Stickel's participation status in any given network, we will file with all insurance companies in all networks to include Aetna, Mailhandlers, Humana, Blue Cross Blue Shield and more. Dr. Stickel is an active participating provider in the following networks:
- Private Hcalthcare Systems (PHCS)
- Healthcare Inc. (HCI)
- Choice Care Network
- First Health
- Cor Care Network (formerly Corvel)
- Healthcare Concepts
- Heritage Summit Healthcare of Florida (HSHC)
- Health Plan of Florida (HIP)
- Guardian Resources Inc.
- One Health Plan of Florida
- Vincam Network (QRS Managed Care Services)
- Aetna
- Cigna
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Each of these networks service several different insurance companies. Your insurance company's network should be listed on your insurance card.
Florida Law is very clear with regards to physicians and the reducing or forgiving of a patient's deductible and/or co-payments, to do so is fraud and it's illegal. If you have insurance, you must pay your deductible and any co-pays as outlined in your policy. While confirming your chiropractic benefits, we are also able to find out what your financial responsibility is, pass the information on to you, and answer any questions you may have. We can also devise a treatment plan that best suits your needs both medically and financially.
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Automobile Accident Injuries
If your injuries are the result of an automobile accident, there are some important facts you need to know. In the State of Florida, it is mandatory that each vehicle carry Personal Injury Protection (PIP) which covers 80% of your medical care up to the maximum benefit level (usually $10,000). There is additional coverage that can be purchased to supplement your PIP coverage called "med-pay" (medical payments) that picks up 100% of your medical bills which exceed your maximum PIP benefits. Your uninsured motorist coverage or private health insurance can also assist in paying your medical bills resulting from an automobile crash; however, your PIP comes first.
On June 4, 1971, the Florida Legislature passed the "no-fault law" which took effect on January 1, 1972, and remins in effect today. This means that regardless of who is at fault, YOUR personal Injury Protection (PIP) will be the first to be responsible for YOUR (or your family's) medical bills for injuries sustained as a result of a car crash. The popular opinion is that the insurance company representing the driver at fault should should be held responsible for payment of all medical bills; however, the No-Fault Law is your protection and assurance that whether or not the driver at fault even has auto insurance coverage (and in many cases they do not), you will be able to receive proper medial care without the full financial burden you would have otherwise been left with.
Dr. Stickel is a Certified Disability Evaluator, and is trained in determining whether or not a permanent impairment has occurred, as well as specializing in the care necessary to treat injuries commonly sustained in automobile accidents. It is important for you or your attorney to know if there is a permanent impairment when dealing with the insurance company representing the driver at fault.
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IMPORTANT: Since the pain or other symptoms of an automobile accident injury are not always apparent at the time of the accident, you should report any collision and/or injury to your automobile insurance carrier immediately. In fact, some injuries are hidden so well that they may be missed by emergency room technicians, and may take weeks, months, or even years before actual symptoms show. It is important not to settle with your insurance carrier until you have had a thorough examination by someone trained in diagnosing and treating these types of soft tissue injuries. You are entitled to this initial evaluation even if you have no apparent symptoms, and your PIP benefits will pay.
Should you require legal representation with regards to your automobile accident injuries, Dr. Stickel has the training necessary to assist your attorney in any way needed. As stated earlier, Dr. Stickel is a Certified Independent Chiropractic Examiner through A.D.E.R.l. (American Disability Evaluation Institute) and is able to give expert court testimony should it become necessary, Dr. Stickel is also able to prepare a final medical narrative, which outlines any permanent impairment you may have, based on the American Medical Association's Guides to the Evaluation of Permanent Impairment, 5th edition, if your attorney should request this in your behalf.
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Workers' Compensation
If you have been injured on the job, your right to file a workers' compensation claim is protected under Florida Law. Your first step is to report the injury to your supervisor immediately. Even if you don't feel injured at the time, pain and irritation can later develop that may require care.
Once your injury or accident has been reported to your supervisor and he has in turn reported it to the workers' comp insurance carrier, you must deal directly with the carrier for pre-approval of any care received from this point on until you are released from care. You may initially be sent to a general practitioner; however, if you desire to see a chiropractic physician, you can request this. If the original physician seen does not refer you, go directly to the workers' comp. adjuster and make known your desire to see a chiropractor. Your workers' comp carrier should be able to supply you with a list of chiropractic physicians that participate in their managed care network.
Studies show that in many cases, chiropractic treatment can get injured workers back on the job faster than other types of care. Workers' compensation insurance carriers acknowledge and pay for chiropractic care. As with all care received under workers' compensation, there is no out of pocket expense to you. Your care has already been paid for by your employer in premiums paid to the workers' compensation insurance carrier. Florida's workers' compensation regulations allow up to 24 chiropractic visits or 12 weeks of chiropractic care, which ever comes first. Since there is a time limit to work with, the sooner you are evaluated by a chiropractor trained in diagnosing work related injuries, and the sooner you begin treatment by a chiropractic physician who specializes in the treatment of work related injuries, the better your chances will be of seeing greater improvement and/or complete resolve of your injury. |
| Dr. T.J. Stickel, D.C., P.A.
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