• ABN - GENERAL INSURANCE

  • ADVANCED BENEFICIARY NOTICE OF NON-COVERAGE

    INSURANCE
  • Health insurance requires that you are notified in advance of services that are not covered by your Chiropractic coverage. Chiropractic coverage typically covers spinal manipulation and some modalities such as muscle stimulation.

    Many of the services provided at Hygiea Health are foundational for the treatment programs we offer. The fees for these services are:

    Wellness Evaluation: $200

    Wellness Re-evaluation: $180

    Bio-feedback: $90

    PEMF: $90

    Kinesiology: $90

    Energy modalities: $90

    Nutritional products: Retail price

    Since we perform a Chiropractic service at every visit, your co-pay each visit will be the difference between $90 and the payment we receive from your insurance company.

    You should be aware that many Chirporactors do not provide non-covered services and will accept your insurance as payment in full plus any deductible or -co-pay you may owe.

    Signing below acknowleges that you have received and understand this notice. You may request a copy of this notice as well.

     

  • Clear
  •  - -
  • Should be Empty: