When you’re seeking relief from pain caused by an accident, injury, or muscle strain, or just looking for a natural healthcare approach, our Chiropractic and/or Acupuncture Benefits may be able to assist you. These benefits offered by PhysMetrics provide you access to licensed professionals at a discounted rate.
| Chiropractic Plan Highlights | Medical Plan Options A, B & C |
|---|---|
| Chiropractic Services by PhysMetrics Provider (deductible waived) | $5 Copay then 100% of the PhysMetrics contract rate |
| Chiropractic Services by Non-PhysMetrics Provider (after deductible) – Outside 100 miles of Fresno ONLY – Referral must be given by a Physician & Pre-Certified by PhysMetrics | Plan A & C: 60% UCR after $100 deductible Plan B: 50% UCR after $100 deductible |
| Chiropractic Diagnostic X-Ray Benefit (after deductible) | 100% UCR Limited to $100 per Benefit Calendar Year |
| Visits | Up to 28 visits per Calendar Year Note: For treatment exceeding 12 visits per calendar year, chiropractor must submit a “twelve visit review” and PhysMetrics must pre-certify additional visits for the remainder of the calendar year. |
| Acupuncture Medical Plan A & B Highlights | PhysMetrics Provider | Non-PhysMetrics Provider |
|---|---|---|
| Acupuncture Visit (20 visits per Calendar Year) | $20 Copay (Deductible waived) | Up to $20 reimbursement (Deductible waived) |
The above are brief benefit summaries only. Please refer to the Plan Booklet (Plans A and B) and the Kaiser Permanente Evidence of Coverage for additional information.
Note: Acupuncture benefits for Plan Option C are covered through Kaiser facilities at a $15 Copay (deductible waived).
Check out PhysMetrics’ website at www.fusdchiro.com or contact them at 877.519.8839 to discuss how to use the program and find a participating provider near you.