Billing & Insurance 101

Billing & Insurance 101 at Lincoln Square Chiropractic

Navigating insurance and billing for chiropractic care doesn’t have to be confusing. At Lincoln Square Chiropractic in Chicago’s Lincoln Square neighborhood, we’re committed to transparency and making the process easy to understand. Whether you have Blue Cross Blue Shield of Illinois (BCBS IL) or you're a Veteran using Optum through the VA, here’s what you need to know.

• BCBS IL — in-network provider
• Optum / VA Community Care — in-network for qualified Veterans
   

Being in-network means we’ve agreed to discounted rates with your insurer. This could save you money compared to out-of-network chiropractors.

1. $20 Collections at Time of Service
This charge covers our billing process. It’s not at all your full cost—just a start so we can submit the claim.

2. We File the Claim for You
After your appointment, we send the claim to your insurance, detailing the services provided.

3. We Wait for the EOB (Explanation of Benefits)
Once processed, your insurer determines coverage and sends an EOB to you and us, which includes:

• Amount billed
• What insurance paid
• Your financial responsibility (co-pay or co-insurance)
   

4. Final Payment
Based on your EOB, we’ll let you know if there’s a remaining balance. You pay only what insurance doesn’t cover.

Deductible
The total amount you pay out-of-pocket before insurance starts contributing. Check your plan to know how much is left.

Co-pay
A flat rate (e.g. $20–$30) charged per visit once deductible requirements are met.

Co-insurance
Once your deductible is met, your insurance and you share the cost. For example, 80%/20% split.

Out-of-Pocket Maximum
The most you’ll have to pay in a year. After reaching it, insurance covers 100% for the rest of the plan year.

1. You Must Verify Your Plan
   Call ahead to confirm chiropractic coverage. Ask about:
   • Chiropractic benefits
   • Deductible and what’s applied
   • Co-pay vs co-insurance structure
   • Visit/treatment limits
      

1. We Don’t Confirm Benefits
   Our $20 billing fee applies whether or not you have coverage. We don't verify your insurance ourselves—your call = your certainty.
    
2. Check Limits and Prior Authorizations
   Some plans limit chiropractic visits or services. Others require pre-approval before receiving care.
    
3. Coverage for Accessories/Products
   Some plans may cover supplies like braces or pillows. Ask your insurer if these are included.
    
4. No-Shows and Late Cancellations
   Missed appointments or late cancelations may incur a fee. Check our cancellation policy in the New Patient Info section.
   
   
    

Q: Is out-of-network care an option?
A: We’re in-network only. You’d pay full price and seek reimbursement if allowed by your plan.

Q: What if I don’t have insurance or it’s out-of-network?
A: We still offer the $20 billing and adjust based on your situation—ask us for cash-pay options.

Q: Can I use HSA or FSA funds?
A: Yes—chiropractic care is considered eligible medical expense by most HSA/FSA plans.

Q: What if insurance denies payment?
A: We’ll work with you and your provider to appeal if appropriate. You remain responsible for undisputed balances.

Insurance doesn’t have to be tricky. At Lincoln Square Chiropractic, we make sure your visit is focused on health—not paperwork. Got questions about a specific treatment, visit limit, or deductible? We’re here to help.

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