Medical Billing Forum

General Category => General Questions => : weirdomommy February 21, 2019, 02:22:41 PM

: Chiro Benefits & Eligibility Phrase
: weirdomommy February 21, 2019, 02:22:41 PM

Can someone please tell me what this phrase means "1 VISITS PER 5 YEAR ROLLING START ON FIRST SERVICE FOR ALL PLACES OF TRTMNT. THIS IS AN INDIVIDUAL BENEFIT MAXIMUM." This is for BCBSTX under Professional (Physician) Visit-Office. Thanks!

: Re: Chiro Benefits & Eligibility Phrase
: Michele February 21, 2019, 04:39:05 PM

I have not encountered that before but I believe it means that the patient is allowed 1 visit per 5 years, the 5 years starts on the date of the visit.  So for example if they had a visit today, 2/21/2019 then they would not be eligible again until 2/21/2024.  It is for each member of the family.