West Virginia Code of State Rules
Agency 4 - Chiropractic Examiners
Title 4 - LEGISLATIVE RULE WEST VIRGINIA BOARD OF CHIROPRACTIC EXAMINERS
Series 4-01 - Regulation of Chiropractic Practice
Section 4-1-9 - Pre-Payment Plans
Universal Citation: 4 WV Code of State Rules 4-1-9
Current through Register Vol. XLI, No. 38, September 20, 2024
1-9.3. Certain restrictions shall apply to billing practices involved in pre-payment plans.
1-9.3.a. The sole purpose behind pre-payment
plans must be to provide, in good faith, an affordable healthcare plan to the
patient. In offering a pre-payment plan, a chiropractor must, in good faith,
explain to the patient the scope of the plan, the patient's rights and
responsibilities under the plan, the cost of the plan, and the treatment that
will be rendered under the plan.
1-9.3.b. Any contract for a pre-payment plan
must contain, in writing, the following provisions:
1-9.3.b.1. The pre-payment plan must note the
severity of pain from which the patient is suffering at the time the patient
enters into the agreement;
1-9.3.b.2. There shall be a ten (10) day
period during which the patient may withdraw from the pre-payment plan without
penalty;
1-9.3.b.3. The pre-payment
plan shall state specifically and unambiguously the total cost that the patient
will incur under the plan, as well as an estimate of the total cost that the
patient would have incurred had the patient sought treatment outside of a
pre-payment plan;
1-9.3.b.4. The
pre-payment plan shall specifically describe which chiropractic services are
included in the plan and which services are excluded. This description shall
include the time frame and the number of visits that are covered by the plan.
The plan shall also identify how absences of care will be treated under the
plan;
1-9.3.b.5. The pre-payment
plan shall describe how other care shall be handled under the plan if the
patient has a subsequent injuiy that is covered by insurance;
1-9.3.b.6. The pre-payment plan shall have a
clear exit provision that identifies the circumstances under which the plan may
be terminated and how any amounts owed for treatment rendered will be billed to
the patient;
1-9.3.c. A
signed copy of the pre-payment plan shall be maintained in the patient's
treatment file.
Disclaimer: These regulations may not be the most recent version. West Virginia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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