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July 30, 2004
Dear Local 135 Member:
I am writing to
address the number of
inquires that we have had
regarding chiropractic
care. First of all, all
members that are enrolled in
Blue Cross for medical care
and that are eligible for
chiropractic care must use
Blue Cross providers for
chiropractic care. The Blue
Cross chiropractic providers
have agreed to accept
payment on your behalf
according to a fixed fee
schedule up to the plan
maximum. The fee schedule is
attached to this letter for
your convenience. Please
note that if you choose to
go to another provider, you
would be responsible for any
charges which exceed the fee
schedule or the plan
maximum.
For those of you
that are on an HMO plan
(Kaiser or Pacific Care),
you may go to the
chiropractor of your
choice. However, the plan
will only pay according to
the attached fee schedule up
to your plan maximum. You
may seek the services of a
Blue Cross provider however,
the provider is under no
obligation to accept the fee
schedule as payment in
full.
It would be beneficial for
you to take the fee schedule
with you to determine
whether or not your provider
will accept your insurance
as payment in full. If your
provider chooses not to
accept your insurance in
full, you would be
responsible for the
difference.
For example (Blue Cross
members that go to a
non-provider, members that
have an HMO):
If you are a new
patient and see a
chiropractor for an office
visit and your chiropractor
charges $35.00
for a new patient office
visit, the plan would pay
$6.50 once you have
paid your
co-payment (if applicable).
You would be responsible for
any amount that
exceeds the fee
schedule or the plan
maximum.
It is very important
to have your chiropractor
phone prior to treatment to
confirm eligibility, and
benefit information. If you
have any questions regarding
your chiropractic benefits
or your benefits in general,
please do not hesitate to
contact our insurance
department at ext. 8.
In Solidarity,
Mickey Kasparian
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