11/02/2025
Attention patients with Aspirus insurance!
Aspirus recently informed us that effective Nov 1st, they are requiring a 2 week pre-authorization for chiropractic visits.
We are still trying to get clarification on this requirement. Initially they said it was for all adjustments, then after meetings with chiropractic association attorneys and phone calls from doctors, they changed the new requirement to the following.
The initial exam and 6 adjustments will be approved without prior authorization. Anything after that needs a 2 week pre-authorization approval. Which means, after your 6th visit, we must request more approved visits if needed and wait up to 2 weeks, then hope they are approved.
There is a lot of uncertainty with this change. We can not guarantee approval of any care, as it is based on what the insurance company deems medically necessary.
What this means as of right now:
If is has been 6 visits or more since your last exam or re-exam, we will need to complete a low level re-exam on your next visit and we may need to request approval. Any visits not approved will be the patient’s financial responsibility.
Please understand that Aspirus is refusing to give us full clarification and we are doing our best to make sure your visits are covered by insurance, but ultimately, it is in Aspirus’ control to deny your care be covered by your insurance policy.
Please speak with our billing specialist Maggie or Dr Sarah if you have any questions. We also encourage you to reach out to your companies HR director or Aspirus customer service as well. 866-631-5404
If needed, we offer affordable self pay options, which may be less out-of-pocket expenses even with insurance coverage. Dr Sarah is happy to explain individually.