Here are the important things to know about getting the most out of your health insurance benefits:
1. You can choose between using the Honor Box or filing claims with your insurance. Unfortunately, you cannot do both at the same time. Many patients who have a chiropractic benefit on their policy, still decide to simply make payments to the Honor Box ignoring their insurance altogether because overall they find it more convenient and less expensive.
2. We consider HMAA to be the best health insurance in Hawaii for chiropractic. For most of HMAA policy holders all that is required is a $5.00 copay each visit. We’ll bill out the rest to HMAA. HMAA usually will cover 20-40 visits every calendar year.
3. For those with UHA insurance, after the first $10.00 for the first visit, our patients pay for their care up front (usually by purchasing a prepayment option). Every 4-6 weeks we will file a claim on your behalf to UHA for the visits you have had and paid for. UHA will then send you a check in your name to your mailing address. It usually takes about a month for UHA to process the claim.
4. HMSA is the largest health insurer in Hawaii, and as you may expect, it is also the most confusing and most complicated when it comes to receiving your chiropractic benefits. Dr. Shiraki is a non-participating HMSA doctor. What that means is that like UHA members, patients with HMSA (after the first $10.00 visit) must pay for their visits up front and will receive reimbursement from HMSA directly. This is where it gets confusing. HMSA has many, many different plans, all with different chiropractic benefits attached. Most of the HMSA plans have no chiropractic benefit at all. For those that do have a plan with chiropractic benefits, the amounts covered vary greatly. Some plans will reimburse you only $10.00 back per visit. Some may reimburse you a certain percentage back for 8 visits, then require a precertification for any additional visits. The plans vary and are always changing. We highly encourage you to call HMSA customer service directly and find out exactly what your benefits are so that you may decide if it would be best to file for your benefits or simply use the Honor Box.
5. Most of Hawaii Labor Union benefits work like HMSA and UHA. Patients will pay up front and then receive reimbursement directly from their unions. The electricians’ benefits, however, work like HMAA (through HWMG).
5. We do not accept Kaiser, HMA, TRICARE, American Specialty Health, ChiroPlan Hawaii, Aetna, and Quest.
6. We also do not accept Medicare. We do have a very special Honor Box plan for our patients over 65 years of age.
7. We do accept workers’ compensation cases and no-fault cases. Those patients filing claims for injuries from a car accident or while on-the-job pay nothing out-of-pocket. We will take care of all the paperwork and billing.