This is an interesting website. You can actually see PPO specific contracts posted here: http://www.empowerchiro.com/ClientLists.html
- A Testimonial posted says: “Through my membership in your network, in the past 12 months, I have received $38,566.32. Being a member of this network (FHA/EmpowerChiro) is a valuable part of my practice!”
- Join the EmpowerChiro PPO network and start receiving patients with good insurance now! EmpowerChiro has been bringing patients to chiropractors for nearly fifteen years.
Here is a sample PPO network fee schedule you will find on this website:
TEXAS TRUE CHOICE FEE SCHEDULE
CPT DESCRIPTION ALLOWED FEE
98940 CMT (1-2 body regions) $ 25.30
98941 CMT (3-4 body regions) $ 32.20
98942 CMT (5-6 body regions) $ 37.95
98943 CMT (extraspinal, 1 or more regions) $ 25.30
99201 New Patient Initial/focused $ 22.77
99202 New Patient Initial/expanded $ 40.25
99203 New Patient Initial/detailed $ 45.77
99204 New Patient Initial/comprehensive $ 51.75
99205 New Patient Initial/complex $ 57.50
99211 Brief $ 17.82
99212 Focused $ 27.60
99213 Expanded $ 35.19
99214 Detailed (includes re-exam and manip.) $ 42.43
99215 Comprehensive $ 52.09
97260 Manipulation $ 27.60
97010 Hot or cold pack $ 13.80
97012 Traction $ 13.80
97014 Electrical Muscle Stimulation $ 13.80
97016 Vasopneumatic Devices $ 13.80
97024 Diathermy $ 13.80
97026 Infrared $ 13.80
97035 Ultrasound $ 13.80
97124 Massage $ 13.80
97530 Kinetic exercise $ 13.80
72010 Full spine AP/LAT $ 50.02
72020 Spine (single view) $ 28.98
72040 Cervical spine AP/LAT $ 47.72
72050 Cervical complete (4 views) $ 83.49
72052 Davis series (7 views) $113.85
72070 Thoracic spine AP/LAT $ 56.92
72100 Lumbosacral AP/LAT $ 55.43
72110 Lumbosacral with oblique $ 96.02
Note: Any code that is not included in the above CPT codes will be discounted 20 percent off the billed charge.
When payment is made, TTC will send repricing report to FHA then FHA will bill the provider 8% of the allowed amount to cover administrative costs. The allowed amount includes the insurance reimbursement plus the patient’s liability (copay, coinsurance and/or deductible).
Editor’s Note: See the last paragraph in bold – a provider re-pricing fee of 8%. This means that your claims are inflated 8% due to this “fixed cost” repricing fee, but it shows up as a claim cost on the claim side of your ledger. Most employers dont know about this fee.
Just for fun, go to the website listed above, click on Private Health Care System (PHCS) PPO network contract and compate to the Texas True Choice contract.
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