I caution you to ask the chiropractic office verbally and make them confirm they are in the FCH network, verbally.

The chiropractic office may require you to sign a financial acceptance form. Sometimes referred to as a “medical liability waiver.” This form is an advanced written notice to participants used by medical professionals. It protects medical professionals’ payment for services rendered when services being provided are found to be non-covered by your medical insurance. You are signing with the understanding you will be responsible to pay for non-covered services. This includes services deemed not medically necessary.

Under the current First Choice Health contract with the ILWU-PMA Benefit Plans, Non-Covered Services/Exclusions reads: Provider shall provide notice to Participant of Participant’s personal financial obligations for non-covered services, which includes services that are not Medically Necessary. Provider may bill a Participant for non-covered services only if Provider has, prior to the provision of non-covered services, obtained a written acknowledgement and acceptance of financial responsibility for such services from the Participant after full disclosure to Participant of (i) Provider’s intent to bill Participant for non-covered services, and (ii) the non-liability of FCHN or Payors for such non-covered services.

If you refuse to sign the financial acceptance form, the Chiropractor can legally refuse to treat you.

A FCH in-network provider should NEVER request money upfront for services they have not yet performed. You do not have “co-pays” or deductibles the chiropractic office would be collecting. If a FCH in-network Chiropractic doctor is requesting payment upfront, in any dollar amount, the office should be reported to First Choice Health. First Choice Health (FCH) has confirmed this is a violation of their contract. First Choice Health’s phone number is located on the back of your medical card. (800) 231-6935.

As of August 31, 2023, ICM will be providing voluntary pre-certification for chiropractic benefits. If you or your provider would like to determine whether a procedure or treatment is covered under the terms of the plan, or if an alternative service is recommended, contact ICM at 866-275-1014, Monday through Friday, 7:00 AM to 5:00 PM Pacific time. This program is voluntary and not mandatory. The best way to request pre-certification is via email to ILWUPMAChiro@innovativecare.com.

Your chiropractor may be required, upon request, to send in medical necessity documentation to Innovative Care Management (ICM) pertaining to your medical claims. You should be vocal about this understanding to your chiropractor. The best way to send medical records to ICM is via email to ILWUPMAChiro@innovativecare.com. When your provider emails your medical records to ICM, ask them to include YOUR email address as well. This will give you and your provider an electronic time stamp showing proof the medical records were sent to ICM.

Open all mail pertaining to your medical bills. If you have questions, please ask them. You can contact WA AREA Welfare Director, Andrea Stevenson. Email, astevenson@benefitplans.org (206) 938-6720 office. - (206) 938-6726 fax.

SUMMARY OF MATERIAL MODIFICATIONS

Important Notice
Regarding Your ILWU-PMA Welfare Plan Coverage

To: All Eligible ILWU-PMA Welfare Plan CIP, HMO and Medicare Enrollees

Subject: Chiropractic Care for CIP, HMO and Medicare Enrollees

Chiropractic Care for CIP, HMO and Medicare Enrollees