by Dr. Theodore R. Herazy, DC, LAc
Back pain is very common. Caring for a bad back can be very expensive, although the costs can be reduced.
Low back pain is the 5th most common reason patients see a doctor for any type of health problem. When a patient goes to a doctor specifically for pain the number one area of complaint is the low back.
It is estimated that $48-$55 billion is spent annually treating the low back. Of all treatment provided for low back pain, 46% is provided by a chiropractic doctor.
In the past 20 years the number of annual chiropractic office visits has nearly doubled. As the Consumer Reports magazine states, this has probably occurred because chiropractors have the highest patient satisfaction rate for treatment of low back pain among all care providers.
Still, it is expensive going to the doctor of chiropractic. Depending on where you live in the U.S. the cost for a first time visit ranges from $70 to $160; subsequent visits range from $34 to $106 each; the national average cost is $65 per visit.
Anything you can do to reduce the frequency of those chiropractic office visits will protect your budget.
Almost all cases of low back pain tend to flare up periodically – some more than others – because back problems over time tend to slowly deteriorate as we age. Even with insurance coverage, and certainly without insurance coverage, keeping this expense controlled is the wise and frugal thing to do.
To help reduce the cost of going to the chiropractor for a back problem (and many other problems as well) it is effective to follow these simple measures:
1. Better Care for Your Back
Take better care of your back so you do not need chiropractic care in the first place.
- Keep your back limber with a daily routine of low back stretching exercise.
- Lose a few pounds to improve posture and reduce stress on your low back and knees.
- Avoid high-impact exercises, like running on concrete, basketball, tennis and horseback riding.
- Do low-impact exercises, like (bicycling and swimming).
- Warm up and stretch before doing work or exercise that involves the low back.
- Take a few chondroitin sulfate supplements daily to rebuild worn low back cartilage.
- Reduce dietary intake of the Three White’s (salt, sugar and refined white flour).
- Stop smoking cigarettes.
Changing your health habits in this way will result in less back stress, a reduced tendency toward spinal arthritis, fewer visits to the chiropractor, and better overall health that reduces medical expenses throughout life.
2. Do-It-Yourself Techniques
When you are at the chiropractor’s office next time ask for two things:
A. Specific exercises to tone up muscles and stretch tight joints in your area of complaint. Make these exercises part of your daily exercise routine.
B. Specific ways you can gently stretch or turn your low back, or leverage your spine while lying down, that might assist an easy self-correction of your back problem.
If your spine happens to easily slip out of alignment, it is logical that it might just as easily slip back into place if you do it correctly. It is sometimes possible to make these corrections without any force or sudden movement at all because you have time and deep relaxation working in your favor.
Many patients help themselves by learning how to mimic the basic position their chiropractor puts them in. By simply holding the body in a particular twisted or tipped position for 10-15 minutes, while staying completely relaxed, a spinal correction can take place if the problem is simple.
Ask your chiropractor how you might position yourself safely and effectively to help your back this way.
This can save you big money by going to the chiropractor only for more complex alignment problems you cannot take care of at home.
3. More Do-It-Yourself
For a sudden and uncomplicated episode of mild to moderate back pain (after gardening or sleeping in an odd position), try a few simple at-home measures first before making an appointment to see the chiropractor.
However, if you have severe and overwhelming pain, high fever, bleeding or inability to urinate or move your bowels with your back pain, you should immediately seek help at the hospital ER.
Otherwise, for a simple case of common back pain, first rest the painful area, ice it and take low dose over-the-counter pain medications for the first week after spinal pain starts. At least 94% of mild to moderate back and neck pain will resolve within two weeks or less using this standard low-cost self-care approach.
If your pain continues after two weeks of doing all this, then see your chiropractor for additional help.
4. Skip the Expensive Back Massage
The pampering touch of a massage therapist at the chiropractor’s office does feel great, but it is expensive. Instead you can reduce a lot of back muscle tension and pain at no cost at all.
Apply direct pressure to the painful area by putting a tennis ball on your mattress or the floor and lying down on it. Position the tennis ball so it applies a gentle direct pressure for five minutes to knotted muscles and painful areas in the low back, buttock or wherever tension is felt.
5. Delay Expensive Procedures
Ask your chiropractor if an expensive procedure can be delayed. Don’t be argumentative or demanding; simply ask if a lab test or x-rays can be delayed a few days to see if your problem can be resolved without the added expense of tests.
6. Discuss Cost Before Any Service Is Provided
Ask about costs of all x-rays, lab work, orthopedic supports and related care before they are done. This avoids problems and regret later when you see the bill. Your doctor will appreciate your honesty if a treatment or procedure is more than you want to spend.
7. Be Candid About Finances
If you are unemployed, short on cash, or carry a high insurance deductible, explain that to the doctor. This information will be kept in mind as your treatment proceeds.
8. Ask for Discounts
Ask for a discount if it feels appropriate. In addition to being a doctor your chiropractor is also a person who understands business. Most business people today would rather keep a customer at a discount than lose them entirely.
Ask the doctor for a small discount when you are in a private setting, not in the middle of the waiting room. Do not ask anyone else since it is unlikely the office staff is authorized to lower or waive fees the way the doctor can.
A 2005 Wall Street Journal Online/Harris Health-Care Poll states that 61% of adults who negotiated with their doctor about office fees and expenses were successful, up from 54 % in 2002.
9. Look for Errors in Medical Bills
Review all medical bills carefully while you are still in the office. If an error is found, get the bill corrected while the facts are still fresh in your memory.
Medical claims management companies report that 70% of all medical bills contain at least one error. It is very common for these billing errors to be against the patient, so the potential for savings could be small or large but always worth the effort.
10. Check Insurance for In-Network Chiropractor
Use a chiropractor who is in-network with your insurance company, since this is where the greatest savings are given.
Doctors leave and re-enter insurance networks often, so check to make sure your chiropractor who was in-network for your last problem is still enrolled and active in your plan.
11. Review Medicare Booklet
Read your Medicare or group insurance benefits booklet. Be sure your insurance coverage is paying for your care as well as it should.
12. Change to High Deductible Insurance
Change to a high deductible insurance coverage if you are young, healthy and do not have young children at home to protect. You will save on monthly premium costs because you will have to pay a higher deductible portion of your medical costs when you do file a claim.
13. Join a Discount Insurance Club
Join a discount insurance club for à la carte private insurance coverage for unique or specialized services like chiropractic or acupuncture treatment.
If you have a chronic back problem that requires frequent chiropractic care you will pay an additional $12-30 monthly fee to qualify for a 50-60% discount for these special services.
14. Join the Farm Bureau if Self-Employed
If you are self-employed join the Farm Bureau for about $30-50 annually. You do not have to be a farmer or live in a rural area to become a member. You will receive discounted insurance rates that are available as a member of a large group plan.
15. Use Flexible Spending Account (FSA) at Work
Use a flexible spending account (FSA) if it is available at work for tax-sheltered benefits.
All it takes is that you do a little bit of calculation for what your medical expenses might be during the coming year. You put that amount of money aside each year to pay your out-of-pocket medical costs, like a visit to the chiropractor.
Your HR department at work can explain all the details.
16. Review Insurance Policy Rules
Closely follow insurance policy procedures and rules, especially for pre-approval of chiropractic services and referrals.
Working within the system outlined in the insurance policy manual prevents payment problems and surprises later when you expect your chiropractor’s bills to be paid.
17. Formal Appeal to Handle Insurance Disputes
Handle insurance disputes correctly for best reimbursement.
If your insurance policy does not cover a chiropractic service you think should be covered, make a formal appeal following the correct procedure outlined in the insurance policy manual.
Or, simply contact your state insurance commission office for help to settle the dispute.
18. Call Toll-Free Numbers to Contact Insurance
Avoid spending money when calling about an insurance claim. Always contact the insurance company with their toll-free phone number.
Avoid calling on a Monday or calling early in the morning since these are the busiest times; call in the early to mid-afternoon for shortest wait times.
(Dr. Theodore R. Herazy retired in 2010 from 42 years of active practice during which he was one of a few people to hold dual licensure in different health care disciplines: chiropractic and acupuncture. Since then he maintains a website, Dr. Lumbago, that is devoted to presenting information and answering questions about the non-drug and non-surgical treatment of painful neck and back conditions.)
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