Welcome to Sunshine Chiropractic Center P.C.



Sunshine Chiropractic Center PC Payment Policy


   Sunshine Chiropractic Center, P.C. is committed to providing the best treatment to our patients. Our fees have been determined for our area by the Resource Based Relative Value Studies (RBRVS) system. Three components are included in this price. They are Professional Expense, Practice Expense, and Malpractice Expense. This total Relative Value Unit (RVU) is the base foundation for payment by Medicare and other payers that use RBRVS reimbursement system.  56% of the RVU is for the professional services and malpractice components. The remaining 44% of the RVU for a service code is for practice expense overhead, both direct and indirect. Significantly, the Indirect Practice Expense of an RVU is for human resources (people). It takes staffing and other associated resources to deal with insurance processing and associated accounts receivable maintenance matters.

 1. Major Medical Insurance: We do not accept assignment from insurance companies. Therefore you must remit payment in full at the time of service. We will submit your claims on your behalf. Your insurance company may need you to supply additional information other than the information we submitted on your claim form. You will need to follow up with your insurance company when you receive your Explanation of Benefits if you disagree with your reimbursement amount.

 2. Medicare Patients: We do not accept assignment from Medicare. This means you will be expected to pay your bill in full at the time of service. We will bill Medicare for you and they will send you a check directly. Medicare specifically needs the patient to state all areas of concern on the symptom sheet-first line. They do not cover anything but the spine. They will not cover a service if it looks like maintenance care. Maintenance care example: If you have injured yourself many years ago and report ongoing symptoms such as aching or dullness. If however you report an increase of symptoms, whether a slight flare-up or a very acute return of symptoms, you must fill out on the Medicare form with info as to when, how, and where it happened. Medicare will then cover the visit. For those who have a secondary Insurance or Medigap, Medicare will forward your claim directly. For those insurances that do not automatically forward, you will need to bill your own insurance company, since you will be the recipient of the Explanation of Benefits (EOB). For those without secondary coverage we can set up a cash account for service not covered by Medicare.

   3. Cash Patients: If you pay in full at the time of service (TOS) the modifier-52 has been added to show that the practice expense has been reduced. You may choose to bill your own insurance company in order to receive this discount. If diagnostic coding is requested by you, you will not receive the discount for the evaluation(s). If for any reason we have to bill you, after your date of service or you later ask to have your services sent to a third party of any type (including collections), you will be responsible for the full standard amount that includes administration fees and any other fees that apply.

 4. Cancellations/No Shows: A fee is charged for any cancellations less than 24 hours or no shows. The fees for missed appointments are as follows:  $30 for a 30-minute office visit, $45 for a 45-minute office visit, and $60 for a 60-minute office visit.  In case of office error, patients must bring their appointment card to avoid the no-show charges. Appointments made over the phone, patients take on full responsibility for their appointments. Cancellations/No shows charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment or by calling us in time to allow us to fill that slot with someone on the waiting list.

  5. Record Requests: Per Oregon State Law the fee for copies of your records is $30.00 for ten or fewer pages and an additional $5.00 will apply if records are mailed within 7 days of request. There will be an additional charge of 0.50 per page for each additional page (11-50), then 0.25 per page for each additional page (51 and up ). Postage will also be added into the overall charge. The rates listed are subject to change without notice.

  6. Case Changes: I understand that if my case changes, (i.e.: cash to Medicare, change of insurance companies, loss of insurance, etc.) it is my sole responsibility to inform Sunshine Chiropractic Center P.C and provide the necessary information to change my case. If I fail to do so, I accept the costs involved in correcting my case.


7. Balances Past Due: If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated.  Please be aware that if a balance remains unpaid, we may refer your account to a collection agency.


Collection Agency Placement Policy: You are financially responsible for the timely payment of your outstanding bill per our payment policies. You will be responsible for any and all collection agency fees up to 50% of the amount placed with, or assigned to the collection agency. In the event we seek legal action for the collection on your account, you may also be responsible for any and all fees associated with court costs, garnishments, and/or attorney fees.

8. Accepted forms of payment: We accept the following Credit Cards with the Visa, MasterCard and Discovery logo and Debit Cards. If you wish to use your Visa/Master Card, Discover Card or Debit Card there is a 4% processing fee. We also accept checks and cash.


We reserve the right to change or amend a policy at any time without notification.