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Insurance & billing

Insurance, billing and payment

LeGault Chiropractic is in network with UPMC, Highmark, Aetna, UnitedHealthcare, other Blue Cross Blue Shield plans and Medicare (participating). It bills auto insurance (first-party medical benefits, often called PIP) and workers’ compensation. Coverage depends on your plan.

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Do you take my insurance?

We are in network with the plans listed below, and what your plan pays for chiropractic care depends on your plan.

Choose your insurer to see how we work with it. The full list is in the table below.

Plans we accept and how billing works
Plan and our statusWhat to know
UPMCIn networkCoverage depends on your plan.
HighmarkIn networkCoverage depends on your plan.
AetnaIn networkCoverage depends on your plan.
UnitedHealthcareIn networkCoverage depends on your plan.
Other Blue Cross Blue Shield plansIn networkCoverage depends on your plan.
MedicareParticipating providerCoverage depends on your plan. See what Medicare covers below.
Pennsylvania auto insuranceBilled directlyFirst-party medical benefits (often called PIP). After a car accident, when we bill your auto insurance you pay nothing up front.
Workers’ compensationBilled directlyCall us with your claim details before your first visit.

Don’t see your insurer? Call 412-364-4100 and ask, or check with your insurer directly. Self-pay options are also available.

Can you check my benefits before my first visit?

We can verify and check your benefits before your first visit or you can check with your insurer directly.

To have us check, call 412-364-4100 with your insurance card in hand. If you would rather ask your insurer yourself, call the member services number on your card and ask:

  • Is chiropractic care covered under my plan?
  • Is there a limit on the number of chiropractic visits each year?
  • What will my copay, coinsurance or deductible be?
  • Does my plan need a referral for chiropractic care?

What will I pay?

That depends on your plan: we send the claim to your insurance, and you pay any part of the bill your plan does not cover.

We submit claims to your insurance for you. Insurance may not pay 100% of a bill, and you are responsible for any amount your plan does not pay.

All billing for care at the office comes from LeGault Chiropractic, PC as one statement.

Questions about a statement? Call 412-364-4100 and we will go through it with you.

Do I need a referral?

The practice does not require a referral; some insurance plans may require one for coverage, so check your plan.

The quickest way to find out is to ask your insurer when you check your benefits.

Is Medicare accepted?

Yes: LeGault Chiropractic is a participating Medicare provider, and coverage depends on your plan.

Medicare Part B covers spinal adjustments by a chiropractor when Medicare’s conditions are met. It does not cover other services or tests a chiropractor orders, such as X-rays. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Medicare.gov: chiropractic services (opens another site) explains the details.

If your Medicare comes through a private Medicare Advantage plan, what it pays depends on that plan. Call 412-364-4100 and we can check your benefits before your first visit.

Were you hurt in a car accident?

We bill your auto insurance directly, and when we do, you pay nothing up front.

First-party medical benefits are the medical coverage in your own Pennsylvania auto policy; the state’s Insurance Department explains that they pay medical bills for you and others your policy covers, regardless of fault. What your auto insurance pays depends on your policy.

Read about car accident care and how we bill auto insurance, or learn how PA first-party benefits and tort options work.

Is it a work injury?

We bill workers’ compensation, so call us with your claim details before your first visit.

The Pennsylvania Department of Labor & Industry’s guide for injured workers explains the basics:

  • Report the injury to your employer or supervisor right away. If your employer does not already know and you give notice more than 21 days after the injury, compensation is not due until you do; notice must be given no later than 120 days after the injury for compensation to be allowed.
  • If your employer has accepted your claim and posted a list of at least six designated health care providers, you are required to see a provider on that list for your first treatment and to keep treating with listed providers for 90 days after that first visit. You may choose any provider on the list.
  • If you see a provider who is not on the list during those 90 days, your employer or its insurer may refuse to pay for that treatment.
  • After the 90 days, or if your employer has no posted list or an improper one, you may choose any physician or other health care provider, and you must tell your employer which provider you have selected.
  • Health care for an accepted work injury is paid at the state fee schedule rate, and you may not be charged the difference between a provider’s charge and the amount paid.

Because the posted list and the 90-day period can decide who pays, check whether your employer has posted a list, then call 412-364-4100 with your claim details before your first visit.

Learn how we care for back or neck injuries from work, from the first exam to exercises you can do at home.

Can I use an HSA or FSA card?

Yes: HSA and FSA cards are accepted.

Your account administrator can tell you which costs your account covers.

What if I pay for care myself?

Self-pay options are available; please call the office to ask about fees.

If you don’t have insurance, or choose not to use it, you have the right to an estimate of expected charges. Our Good Faith Estimate notice explains how it works.

How can I pay my bill?

You can pay online with Square or Venmo, by phone, in the office, or by mailed check.

Use our Pay my bill page to pay your bill online or to see who to make a check out to.

Ready for your first visit?

Book online or call 412-364-4100; we can check your benefits before you come in.

Read about your first visit and what to bring, or browse more insurance and Medicare questions in our FAQ.

Book an appointmentCall 412-364-4100

Questions, answered

If you’re in network with my insurer, is my care covered?

Not automatically. Being in network means we work with your insurer and send claims to it; what your plan pays depends on your plan, including any copay, deductible or visit limit.

We can verify and check your benefits before your first visit or you can check with your insurer directly.

My plan is a special product from one of your insurers. Do you take it?

We list insurers rather than every product they sell, so call 412-364-4100 and we can check your benefits for your exact plan before your first visit.

Sources

  1. Medicare.gov: chiropractic services. US Centers for Medicare & Medicaid Services, “Chiropractic services” coverage page (accessed October 14, 2026). (opens another site)

    Part B covers spinal adjustments by a chiropractor when Medicare’s conditions are met, not other services or tests a chiropractor orders such as X-rays; you pay 20% of the Medicare-approved amount after the Part B deductible.

  2. Pennsylvania Insurance Department. Auto Insurance Guide (rev. October 2016). (opens another site)

    Medical benefits pay the medical bills for you and others covered by your policy, regardless of fault; the minimum limit is $5,000.

  3. Pennsylvania Department of Labor & Industry, Bureau of Workers’ Compensation. Workers’ Compensation & the Injured Worker (LIBC-100, rev. January 2023). (opens another site)

    Report injuries right away (notice within 120 days for compensation); a posted list of six or more providers applies for 90 days after the first visit; after that, any provider; no balance billing for covered care.

  4. Pennsylvania Department of Labor & Industry. Physicians list defined (workers’ compensation designated providers). (opens another site)

    A properly posted list of at least six designated providers applies for 90 days from the first visit; the employer may not direct the worker to a specific provider on the list.