At Acupractic Natural Healing Center, serving the Triangle since 1995 with quality chiropractic and acupuncture alternative medical healthcare, we love helping patients get better. As part of our commitment to helping patients, we provide cost-effective treatment and participate in many insurance plans for chiropractic and acupuncture services. As throughout all medical specialties, insurance covers care they deem necessary. Maintenance and supportive care and other noncovered services are the patient’s responsibility. In this post, we explain what maintenance and supportive elective care are, how receiving maintenance care is beneficial, and the insurance guidelines regarding this crucial type of care.

According to insurance websites, maintenance, supportive, and elective care occur when

1. The patient has reached MMI (aka maximum medical improvement). The exam shows no improvement in symptoms and goals over 6-10 visits or one month.
2. Additionally, although many patients benefit from adherence to a treatment plan, especially at the start of care, some people cannot follow one. Patients on maintenance care come in when they want to schedule regular or irregular visits with no identified goal for improvement.

Since insurance guidelines require goals for care that include following a treatment plan, when patients cannot follow a treatment plan, this is maintenance care. Patients struggling to adhere to a treatment plan should discuss their scheduling requirements to make the most of their time and any insurance benefits they have. Alternatively, using maintenance care is an option.

All patients benefit from maintenance and supportive care. At Acupractic Natural Healing Center, we strive to make care accessible, effective, and affordable by offering time-of-visit maintenance care visit prices.

Understanding the Benefits of Maintenance Care

Maintenance and support are essential adjuncts to healthcare; insurance plans generally do not cover this ongoing treatment.

• Maintenance care can be less costly, with set fees for maintenance care generally lower than insurance allows.
• One can use HSA and FSA benefits to pay for maintenance care.
• Patients can come in with more flexibility and not according to a treatment plan, which generally necessitates coming in several times a week for several weeks in the beginning.
• Regularly scheduled maintenance visits prolong good health.
• Maintenance care visits generally do not use up allowed visits per insurance plan guidelines, allowing patients to keep those visits for times of need for acute care.

The Corporate Medical Policy from BCBS Insurance plan defines chiropractic care and explains insurance policies regarding covered services and noncovered care, including maintenance/elective and supportive care. Please note that although insurance generally does not cover or pay for maintenance/elective and supportive care services, the services are deemed helpful and necessary to support one’s health. For instance, many patients benefit from regular chiropractic adjustments to maintain spinal health and mitigate day-to-day stressors, but their insurance plan only covers care needed to improve an existing problem that shows improvement over time according to a treatment plan. Also, sometimes, patients need help to follow a treatment plan. Insurance does not promise to pay for unnecessary care, and we cannot guarantee that a patient’s insurance will pay for services; we are always ready to assist patients who need assistance.

Chiropractic medicine is a science based on the relationship between the structure and function of the human body. Services rendered are intended to support the spinal column and nervous system functions. The American Chiropractic Association published the following definitions: Chiropractic is a healthcare profession that focuses on musculoskeletal and nervous disorders and the effects of these disorders on general health. Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches. Spinal manipulations and other treatment modalities can be provided manually or with mechanical or electrical devices.

Doctors of Chiropractic – often called chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care, including patient examination, diagnosis, and treatment. Chiropractors have broad diagnostic skills and are trained to recommend therapeutic and rehabilitative exercises. Chiropractors will readily refer patients to the appropriate healthcare provider when chiropractic care is not suitable for the patient’s condition or the condition warrants co-management in conjunction with other healthcare team members.

Supportive Care

Supportive care is long-term treatment/care for patients who have reached maximum therapeutic benefit but fail to sustain benefit and progressively deteriorate when there are periodic trials of treatment withdrawal. Supportive care follows the appropriate application of active and passive care, including rehabilitation and lifestyle modifications. Supportive care is appropriate when alternative care options, including home-based self-care or referral, have been considered and attempted. Supportive care may be inappropriate when it interferes with other appropriate primary care or when the risk of supportive care outweighs its benefit, i.e., physician/treatment dependence, somatization, illness behavior, or secondary gain.

Preventive/Maintenance Care

Elective healthcare that is typically long-term, not therapeutically necessary, but is provided at preferably regular intervals to prevent disease, prolong life, promote health, and enhance the quality of life. This care may be provided after maximum therapeutic improvement, without a trial of withdrawal of treatment, to prevent symptomatic deterioration, or it may be initiated with patients without symptoms to promote health and prevent future problems. This care may incorporate screening/evaluation procedures designed to identify developing risks or issues about the patient’s health status and give care/advice for these. Preventive/maintenance care is provided to optimize a patient’s health. Maintenance begins when the therapeutic goals of a treatment plan have been achieved and when no further functional progress is apparent or expected to occur.

At our office, we strive to help patients understand what their insurance covers and collect all noncovered items at the time of service when possible. Ultimately, however, it is the patient’s responsibility to know what their insurance covers. We work with patients to help them get the best healthcare at the best price. Call today at (919) 929-1400, email us at schedule@acudocnc.com or visit our website at acudocnc.com to schedule your healthcare appointment.

At Acupractic Natural Healing Center, the chiropractic and acupuncture offices of Dr. Lisa Oskardmay, we serve the Triangle with quality alternative healthcare and participate with major insurance companies. People call us every day with questions regarding their coverage. Patients want to know their out-of-pocket expenses for examinations, chiropractic care, and acupuncture services. Our insurance specialist strives to help patients understand their coverage to the best of her ability. Generally, she can offer assistance and clarity that helps to ease the confusion and concern about billing. Our office does our best to provide quality care at affordable prices, whether by using their insurance benefits or paying out of pocket. Our main goal is always to help the patient feel better faster.

At some, mostly hospital-based practices, patients are billed much more for care than they may be billed elsewhere, whether they are in the hospital or not. The following explanation from ChatGPT summarizes why this may occur.

1. **Special Agreements**: A hospital may have a special agreement with an insurance company that doesn’t include the typical contractual reductions offered to other providers. This could be due to the hospital’s reputation, quality of care, or specialized services that demand higher rates.
2. **Out-of-Network Status**: Even if a hospital-based clinic is generally in-network, certain services or specific locations might be considered out-of-network under your plan. Out-of-network services typically do not benefit from identical contractual reductions.
3. **Tiered Network Plans**: Some insurance plans have tiered networks, where certain providers are placed in different tiers based on cost or quality metrics. A hospital-based clinic in a higher tier might receive reductions different from those of other providers.
4. **Specific Plan Exclusions**: Your particular insurance plan might exclude specific service reductions, even for in-network providers like the hospital.
5. **Billing Practices**: The hospital-based clinic might have specific billing practices that don’t align with your insurance’s usual reductions, leading to the denial of these discounts.

At Acupractic Natural Healing Center, we do our best to help you understand your bills, charge reasonable and customary charges for quality care, and answer your questions. Dealing with insurance companies and certain healthcare facilities can be stressful. When you choose to receive chiropractic and acupuncture services at our Chapel Hill offices, be confident that we are here to help you however we can. Whether you choose to utilize your insurance or self-pay for care, we will let you know what to expect when you come in and will be your ally when working with your insurance plan.

Call us today at (919) 929-1400, email us at schedule@acudocnc.com or visit our website at acudocnc.com to schedule your appointment today.

The following blog post is from someone we at Acupractic Natural Healing Center know and trust about her experience at a local business offering a different type of healthcare. The author enthusiastically supported the company and had a wonderful, healing experience with Infrared Light therapy. Here is a description of Infrared Light Therapy from the web:

‘Infrared therapy is a new and innovative light-based method to treat pain and inflammation in various body parts. Unlike ultraviolet light, which can damage the skin, infrared light enhances cell regeneration. Infrared light is delivered to the site of injury or inflammation at specific wavelengths, promoting cell repair.

The critical characteristic of infrared light is its ability to penetrate even the deep layers of the skin, providing better pain relief. Also, infrared light is safe, natural, non-invasive, and painless. Thus, it can offer a broad range of health benefits.

Monica’s post:

“I am a daughter, caregiver, mother, wife, sister, friend, mentor, working woman—and the list goes on. Like many, I often forget to take care of myself; therefore, about a year ago, I shifted my thinking and put myself on my calendar so I could begin my self-care and wellness journey with a more holistic approach.

Recently, on this journey, a dear friend introduced me to infrared light saunas. I was not familiar with Infrared light therapy, but after doing some research, I learned of its benefits: it relieves pain, boosts immunity, renews skin, improves circulation, ignites metabolism, and more. I decided to give it a try.

Here’s how it went down: Upon entering Beem Light Sauna – Durham, I was greeted warmly and provided a tablet with video and music streaming services that had already been downloaded. As I entered the sauna, I saw the temp set to 137 degrees, so thank goodness I was prepared with my tumbler of water. To my surprise, it was a dry heat. I was intrigued by the chromotherapy hues that illuminated throughout the session with descriptors for each color noted on the glass. As I relaxed and sweat, I recall thinking that hot flashes were nothing compared to this! When the 40-minute timer beeped, I opened the door to a wonderfully cold, mint cloth to cool me down. I opted to take advantage of the showers before leaving, and to my surprise, I felt energetic and joyful. I couldn’t quite figure out why, but I have been once more since my initial session, which was a repeat experience. I felt like I had a spa-like experience without the price tag.

At this moment, I don’t know if the research I found regarding the benefits is genuinely the case, but I plan to give it 90 days. I will let you know if I begin to look svelte and beautiful like actress Vanessa Williams. Even if I don’t, I am happy to share an update. “

Thank you to Monica for writing this helpful blog post about her experience at Beem Light Sauna in Durham. Our goal at Acupractic Natural Healing Center is to help as many people as possible achieve their best health naturally. Dr. Oskardmay provides chiropractic adjustments, acupuncture treatments, therapeutic massage, nutrition and exercise counseling, and other supportive services. Contact us today at (919) 929-1400, email us at schedule@acudocnc.com or visit our website at acudocnc.com to learn more about how natural healthcare can be your best form of healthcare. 919-929-1400.