insurance estimate

What might your insurance pay you back?

We're an out-of-network, self-pay practice. You pay us for each visit, and we give you a superbill you can submit to your insurance. If your plan pays, it pays you directly.

This page helps you estimate what that could look like for the care plan you're considering, using the numbers your insurer gives you.

Estimate only. Your plan decides what it pays. Check your benefits with your insurer.

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your numbers

Work out your estimate

Fill in what you know. The estimate changes as you type. Under each box is the question to ask your insurer.

This estimate needs JavaScript turned on in your browser. You can still use the questions to ask your insurer, or call us at 734.274.5107.

1Do you have out-of-network chiropractic benefits?

Ask your insurer: "Do I have out-of-network chiropractic benefits?"

Yes No Not sure

2Visits allowed per year

Ask: "How many out-of-network chiropractic visits does my plan allow each year?" Many plans allow 10, 24 or 30.

10 24 30 Other

3Visits already used this year

Ask: "How many chiropractic visits have I used this plan year?" Count visits anywhere, not only here.

Visits remaining: –

4Visits in the care plan you're considering

If Dr. Lazar finds you need a plan of care, the number of visits is in your written care plan.

5Fee per visit at Lazar Upper Cervical

What you pay us for each visit. Use the amount from your care plan.

6What your plan allows per visit (allowed amount)

Ask: "What is the out-of-network allowed amount for CPT 98940?" Left blank, the estimate assumes your plan allows our full fee. Most plans allow less.

7Deductible remaining (out-of-network)

Ask: "How much of my out-of-network deductible is left this year?" It comes off first, before your plan pays anything.

8Your cost share

Co-insurance % Flat copay $

Your co-insurance

For example, 30% means your plan pays 70% of the allowed amount after the deductible.

9Optional: out-of-network out-of-pocket maximum remaining

Ask: "How much of my out-of-network out-of-pocket maximum is left?" Once your share reaches it, your plan pays the full allowed amount.

estimate only

Your estimate

To see your estimate, fill in the boxes.

Estimated reimbursement check(s) to you: –
Your total payments to the practice: –
Your estimated net cost: –
Estimated net cost per visit: –

Estimate only. Your plan decides what it pays. Check your benefits with your insurer.

Visit by visit

Where your deductible is used up, and where your plan's visit limit is reached. Visits that are the same are grouped.

Visit	You pay us	Toward deductible	Your co-insurance or copay	Estimated back to you	Note

before you call your insurer

Questions to ask your insurer

Call the member services number on your insurance card. Write the answers down, with the date and the name of the person you spoke with.

Do I have out-of-network chiropractic benefits?
How many chiropractic visits does my plan allow each year, and how many have I used?
How much of my out-of-network deductible is left?
After the deductible, what is my out-of-network co-insurance or copay for a chiropractic visit?
What is the out-of-network allowed amount for CPT 98940?
What is my out-of-network out-of-pocket maximum, and how much of it is left?
If I submit a superbill, is reimbursement paid to me, the member?

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How the estimate is worked out

Only the visits your plan still allows are counted: the smaller of your care plan's visits and your visits remaining. Visits past that limit are estimated at $0 back.

For each counted visit, the allowed amount is your plan's amount or our fee, whichever is lower. Your deductible comes off first. With co-insurance, your plan pays its percentage of what's left; with a copay, it pays what's left after your copay. If you add an out-of-pocket maximum, once your share reaches it your plan pays the full allowed amount.

Your net cost is what you pay us, less the estimated reimbursement.

Who does the paperwork?

We give you a superbill you can submit to your insurance. You submit it, and your plan decides what it pays and sends any reimbursement to you. Questions? Call 734.274.5107 or write to hello@lazaruppercervical.com.

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