Best Chiropractic Services in Boonsboro, VA

Dr. Werth focuses on the nervous, muscular, and skeletal systems including the connective tissues between them. Common issues include low back and neck pain, headache, disc bulge and herniation, sciatica, various forms of arthritis, widespread pain/fibromyalgia, carpal tunnel syndrome, and extremity pain (shoulder, hand, hip, knee, ankle, etc.). This is not an exhaustive list, so call if you have any questions!

We are in-network if you have:
– Anthem Blue Cross Blue Shield PPO (not HealthKeepers/HealthKeepers Plus)
– Piedmont Community Health Plan
– Sentara Health*
– Cigna
– Medicare (Part B)
– Sana Benefits
– VA Community Care Network

If any of these payors pertain to you, please provide the necessary information on our intake form.

*Virginia Medicaid through Sentara Health does not fully cover chiropractic care. In the past, our evaluation and physiotherapies have been covered by specific plans but only on an individual basis. Medicaid patients will be treated as self-pay upfront with reimbursement provided later if services are covered by VA Medicaid.”

You do not. Chiropractors are direct-access providers. If you are referred by another doctor, kindly share this with us and we will incorporate them in your care, as appropriate.

Traditional Medicare (Part B) covers spinal manipulative therapy (a.k.a. chiropractic adjustments) for active conditions involving the spine necessitating treatment. An active condition is one that is either a new (acute) injury or a chronic condition expected to be improved with continued therapy. Once healing or stability has been achieved, further SMT is considered maintenance therapy and is not covered.

Medicare Advantage (Part C) plans that are sold by private insurance companies cover all or part of the SMT traditional Medicare applies to a member’s deductible and/or 20% coinsurance thereafter. In some specific cases, diagnostic and/or therapeutic services other than SMT can be covered by Medicare Advantage plans, but this will need to be verified on an individual basis and is subject to change. In the end, all financial responsibility falls to the patient if the primary, secondary, or tertiary insurance policy fails to cover services.

Reference: CMS Medical Policy Article A57889, January 1 2020

According to the Virginia Department of Medical Assistance Services (DMAS) Handbook, Medicaid does not fully cover chiropractic services for adults. However, Medicaid members under the age of 21 and through the DMAS Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program may have chiropractic services covered when it is medically necessary and with prior approval from the DMAS. At this time, we are not directly in-network with Medicaid EPSDT but can provide you with all the necessary information to seek reimbursement from your plan after paying for your child’s visit.

This said, our evaluation and physiotherapies may be covered by Sentara Community Plan but only on an individual basis. Medicaid patients will be treated as self-pay upfront with reimbursement provided later if services are covered by VA Medicaid.

Reference: Medical Assistance Handbook English 7.2022.pdf (coverva.org) pg. 29 and medallion-40-contract-sfy21v3.pdf (virginia.gov) pg. 416

Being out-of-network means we give you the task of working with your insurance company to cover all or part of your chiropractic care after paying in full for our service(s) at the time of service. You will take a receipt (a.k.a. superbill) to your insurance company for coverage and we are glad to assist you in any way we can. In many cases we can submit this superbill on your behalf but please clarify this intention with us at the time of service.

If services are not covered and we are in-network with your insurance (as is the case with some Medicare claims), the insured is responsible for covering the cost of the service(s) at our self-pay rate.